Challenges in Healthcare Management Models in The Country of Georgia and Proposed Solutions

Abstract

The article "Problems in Georgia's Health Care Management System and the Proposed Solutions" examines the impact of ongoing health care reforms in Georgia on the overall health status of the population and its influence on changes in such indicators as the country's demography. The article eexplores both the primary health care system and the secondary care and highlights that despite much interventions and funding coming from donor organizations and the state budget, Georgia's health care system is still far from reaching the European Core Health Indicators (ECHI). Specifically: referral rates to a "family doctor" is low; the proportion of "out-of-pocket" payment is still high; there is a substantial shortage of nurses and a surplus of doctors; low hospital bed occupancy rates; funding for primary care on a "residual principle" remains a challenge and more. Concomitantly, all of the above reflected the demographic indicators of the country, and within the last three decades over the period from 1990 to 2021 the birth rates declined, mortality increased, and average life expectancy decreased. Based on the findings, the authors conclude that it is hard to close the existing gaps the country's health care system is facing by means of a single sectoral approach, and propose a strategy for inter-sectoral management model for health care within one cluster. The article examines a model on the example of the Samtskhe-Javakheti region of Georgia. Keywords: health care reforms; management of reforms; "Family Doctor"; Family Medicine; intersectoral management; cluster.