Romania HiT (2016)

The Romanian population has seen increasing life expectancy and declining mortality rates, however both remain among the worst in the European Union. Some other troubling trends are also apparent; for example, although social health insurance is compulsory, only 86% of the population is actually covered. Those that do have such insurance should have access to a comprehensive benefits package, however, the population seems dissatisfied with both service delivery and quality.

Reform to tackle these and other issues affecting the Romanian health system has frequently proved ineffective, due in part to instability in health governance. Whilst efforts have been made to strengthen the role of primary care, health care provision remains characterized by underprovision of primary and community care and inappropriate use of inpatient and specialized outpatient care. Reforms have been hampered by the relatively low number of physicians and nurses, compared to EU averages, something attributed to the high rates of workers emigrating abroad over the past decade. However, measures introduced to counter these shortages do not seem to have made a difference.

There have been recent and ongoing attempts at improvement and these are viewed by patients and health care professionals as perhaps being fragmented and insufficiently coordinated. Reforms seem to have focused on achieving financial balance at the expense of long-term goals, and lack continuity. In a further complication, a major obstacle to improvement remains ensuring stability in health governance and addressing corruption in health care (and other) sectors.

HiT health system reviews are country-based reports that provide a detailed description of a country's health system and of reform and policy initiatives in progress or under development. More up-to-date information on many countries can be found on our Health Systems and Policy Monitor (HSPM).