Cyprus: Health System Review.

The analysis of the Cyprus health care system reviews all developments related to the newly introduced General Healthcare System (GeSY), in particular in relation to its organization and governance, financing, physical and human resources, provision of service and its performance after 4 years of operation. The implementation of the GeSY created a completely new health care environment, bringing together the public and private sectors into a single and competitive quasi market. Major and fundamental changes are being recorded in all health system areas (including administration, financing and remuneration of providers, coverage, access, freedom of choice, benefits, and financial protection) compared to the old system. The main characteristics of the GeSY are the universality of coverage, funding from contributions levied on people's income and the state budget, the provision of an integrated benefits package, including personal and family care through the introduction of general practitioners (GPs)/personal doctors with a gatekeeping role and a referral system to access specialties and hospitals. The GeSY has improved coverage, the available benefits package, access, freedom of choice and financial protection of beneficiaries compared to the previous system. The population of Cyprus has a relatively good health status with high life expectancy, while few older people relative to the European Union (EU) average report having chronic conditions. There are also low levels of unmet need, and the indexes for both preventable and treatable mortality are well below the EU averages. Diabetes, obesity and smoking remain the main health risk factors. Main challenges and areas for development are: a) the reorganization and reform of public hospitals in order to compete with private ones; b) the introduction and use of e-health, including electronic health records, the regulation of data storage and use of bio information; c) the implementation of university clinics in public hospitals; d) the integration of quality and performance indicators into the compensation mechanisms of GeSY providers; and e) the introduction of medical and therapeutic protocols and guidelines. Finally, a major challenge is the financial sustainability of the system in the long term.