As part of a broader social and economic transition, Romania's health care system underwent major reforms in the 1990s as it was transformed from a centralized, tax-based system to a pluralistic one based on contractual relationships between health care providers and insurance funds. Until the end of the decade, primary care was provided mainly through some 6,000 public-sector dispensaries throughout the country, with each patient assigned to a facility. Patients have subsequently been allowed to choose their own dispensary and general practitioner. Since 1990, general practitioners and specialists have also opened private medical offices. In 1996, there was one doctor for every 553 people. As of 1999, there were an estimated 1.8 physicians and7.6 hospital beds per 1,000 people. In 2002, there were over 164,000 hospital beds in Romania. As of 1999, total health care expenditure was estimated at 4.6% of GDP.
Increased mother and child care lowered the infant mortality rate from 143 per 1,000 live births in 1948 to 19 in 2000. The general health of the population has likewise improved, with several previously serious diseases eliminated or greatly reduced (e.g., diphtheria, tuberculosis), although proper sanitation was available to only 53% of the population and safe drinking water to 58%. As of 1998, leading causes of death were cardiovascular disease, cancer, and respiratory diseases. Overall mortality was 12.3 per 1,000 people as of 2002. Average life expectancy in 2000 was 70 years. There were 240,798 births in 1999. Romania's birth rate in 2002 was an estimated 10.8 per 1,000 people. About 48% of married women (ages 15 to 49) used contraception in 2000. The abortion rate doubled from 1989 (when abortion became legalized) to 1993. The total fertility rate in 2000 was 1.3 children per woman during her childbearing years. Immunization rates for children up to one year old in 1997 were: tuberculosis, 100%; diphtheria, pertussis, and tetanus, 97%; polio, 97%; and measles, 97%.
Tobacco consumption has increased from 1.9 kg (4.2 lbs) in 1984–86 to 2.1 (4.6 lbs) kg a year per adult in 1995. There were more than 160,000 cardiovascular disease deaths in the mid-1990s. As of 1999, the number of people living with HIV/AIDS was estimated at 7,000 and deaths from AIDS that year were estimated at 350. HIV prevalence was 0.02 per 100 adults.