Health systems financing and the path to universal coverage

Evans, David B.; Etienne, Carissa F.

doi:10.2471/blt.10.078741

Cited by 376 publications

(193 citation statements)

References 15 publications

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“…UHC yang dipromosikan World Health Organization (WHO) bertujuan agar masyarakat mendapatkan pelayanan kesehatan yang berkualitas, melindungi orang-orang dari pemiskinan kesehatan dan meningkatkan ekuitas kesehatan ke seluruh kelompok sosial ekonomi (Robertsonet et al, 2013). Pemerintah atau negara perlu mempertimbangkan tiga dimensi utama, yaitu penduduk sebagai penerima manfaat, package, dan proporsi subsidi publik untuk penyediaan layanan kesehatan (Evans and Etienne, 2010).…”

Section: Latar Belakangunclassified

Social Economic Equity in the Utilization of Hemodialysis among Patients with Chronic Renal Failure under National Health Insurance Plan at Dr. Moewardi Hospital, Surakarta

Ardian

Sulaeman

Suryono

2017

J HEALTH POLICY MANAGE

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Section: Latar Belakangunclassified

Social Economic Equity in the Utilization of Hemodialysis among Patients with Chronic Renal Failure under National Health Insurance Plan at Dr. Moewardi Hospital, Surakarta

Ardian

Sulaeman

Suryono

2017

J HEALTH POLICY MANAGE

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“…[1][2][3] Hard decisions must be made to deny services which are effective, but not cost-effective, in order to stay within the budget. In practical terms, it would mean prioritizing primary care in rural areas over specialist services in big urban hospitals.…”

Section: T He World Health Organization's (Who's) Consultativementioning

confidence: 99%

Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries

Ikegami¹

2016

Int J Health Policy Manag

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When the Japanese government adopted Western medicine in the late nineteenth century, it left intact the infrastructure of primary care by giving licenses to the existing practitioners and by initially setting the hurdle for entry into medical school low. Public financing of hospitals was kept minimal so that almost all of their revenue came from patient charges. When social health insurance (SHI) was introduced in 1927, benefits were focused on primary care services delivered by physicians in clinics, and not on hospital services. This was reflected in the development and subsequent revisions of the fee schedule. The policy decisions which have helped to retain primary care services might provide lessons for achieving universal health coverage in low-and middle-income countries (LMICs).

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“…7,8 Establishment of universal health coverage requires systems that raise the bulk of funds through prepayment methods (for example, taxes and/or insurance), and then pool these funds to spread the financial risk of illness across the population. 9 The state of health-care financing in Nepal is weak, as over 60% of the population lacks quality access to basic essential care such as maternity services. 6 In addition to this, high reliance on OOP payments means that health care has a high catastrophic share of household spending, and this can lead to impoverishment or nonaccess by patients, as it is the most inequitable form of health-care financing.…”

Section: Introductionmentioning

confidence: 99%

Access to free health-care services for the poor in tertiary hospitals of western Nepal: a descriptive study

Mahato

Paudel

2015

WHO South-East Asia J Public Health

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background:Nepal is an underdeveloped country in which half of the total health expenditure is from out-of-pocket payments. Thus, the Government of Nepal introduced universal free health-care services up to the level of district hospitals, and targeted these services to poor and marginalized people in regional and subregional hospitals. The aim of this descriptive study was to explore the implementation and utilization of free health-care services by the target population (poor and marginalized people) in two tertiary-care hospitals in western Nepal, one with a social care unit (Western Regional Hospital) and one without a social care unit (Lumbini Zonal Hospital). Methods:Medical records maintained by the two hospitals for one Nepali calendar year were collected and analysed, along with information from key informant interviews with staff from each hospital and patient exit interviews.results: Utilization of free health-care services by poor and marginalized people in the two tertiary-care hospitals was suboptimal: only 8.4% of patients using services were exempted from payment in Western Regional Hospital, whereas it was even fewer, at 2.7%, in Lumbini Zonal Hospital. There was also unintended use of services by nontarget people. Qualitative analysis indicated a lack of awareness of free health-care services among clients, and lack of awareness regarding target groups among staff at the hospitals. Importantly, many services were utilized by people from rural areas adjoining the district in which the hospital was situated.conclusion: Utilization of free health-care services by the target population in the two tertiary-care hospitals was very low. This was the result of poor dissemination of information about the free health-care programme by the hospitals to the target population, and also a lack of knowledge regarding free services and target groups among staff working in these hospitals. Thus, it is imperative to implement educational programmes for hospital staff and for poor and marginalized people. Unintended use of free services was also seen by nontarget groups; this suggests that there should further simplification of the process to identify target groups.

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Health systems financing and the path to universal coverage

Cited by 376 publications

References 15 publications

Social Economic Equity in the Utilization of Hemodialysis among Patients with Chronic Renal Failure under National Health Insurance Plan at Dr. Moewardi Hospital, Surakarta

Social Economic Equity in the Utilization of Hemodialysis among Patients with Chronic Renal Failure under National Health Insurance Plan at Dr. Moewardi Hospital, Surakarta

Achieving Universal Health Coverage by Focusing on Primary Care in Japan: Lessons for Low- and Middle-Income Countries

Access to free health-care services for the poor in tertiary hospitals of western Nepal: a descriptive study

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