Importance of Evidence-Based Health Insurance Reimbursement and Health Technology Assessment for Achieving Universal Health Coverage and Improved Access to Health in India

Dang, Amit; Dang, Dimple; Vallish, B N

doi:10.1016/j.vhri.2020.04.007

Cited by 23 publications

(16 citation statements)

References 24 publications

(42 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…In the context of redesigning the healthcare system, NCG guidelines help standardise cancer care through implementing the health benefits packages and the use of strategic purchasing contracting and provider payments, helping India to achieve UHC. 48 The guideline adaptation framework of the NCG is directly applicable to other disease areas. The principles discussed in this paper, and that are embedded in the approach are universally recognised and are relevant across the whole spectrum of diseases and care.…”

Section: Recommendation Option Definitionmentioning

confidence: 99%

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Ensuring quality in contextualised cancer management guidelines for resource-constraint settings: using a systematic approach

et al. 2022

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To address the wide variation in access to cancer care in India requires strengthening of infrastructure, trained oncology workforce, and minimisation of out-of-pocket expenditures. However, even with major investments, it is unlikely to achieve the same level of infrastructure and expertise across the country. Therefore, a resource stratified approach driven by evidence-based and contextualised clinical guidelines is the need of the hour. The National Cancer Grid has been at the forefront of delivery of standardised cancer care through several of its initiatives, including the resource-stratified guidelines. Development of new guidelines is resource and time intensive, which may not be feasible and can delay the implementation. Adaptation of the existing standard guidelines using the transparent and well-documented methodology with involvement of all stakeholders can be one of the most reasonable pathways. However, the adaptation should be done keeping in mind the context, resource availability, budget impact, investment needed for implementation and acceptability by clinicians, patients, policymakers, and other stakeholders. The present paper provides the framework for systematically developing guidelines through adaptation and contextualisation. The process can be used for other health conditions in resource-constraint settings.

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Section: Discussionmentioning

confidence: 99%

Section: Recommendation Option Definitionmentioning

confidence: 99%

Ensuring quality in contextualised cancer management guidelines for resource-constraint settings: using a systematic approach

et al. 2022

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“…80 According to the National Health Accounts published in October 2019, more than 58% of expenditure on health in India is borne by individual households in the form of OOPE during 2016-17. 81,82 The health system in India relies immensely on OOPE 6,79,83 which is pushing around 7% of the Indian population below the poverty line every year. 84 In Nigeria, the health expenditure is dominated by OOPE.…”

Section: Out-of-pocket Expenditurementioning

confidence: 99%

A public‐private partnership based model for regulating out‐of‐pocket expenditures to strengthen primary care system

Kumar

2022

Health Planning & Management

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In developing countries like India, the cost of health care is largely borne by patient out‐of‐pocket payments. Recent studies have reported that patients skip public‐funded clinics providing free consultation for distant private care providers. Some of the reasons identified for such behaviour include longer waiting times, perception regarding quality of care, etc. Therefore, optimal allocation of existing and new capacity is critical for a greater public interest. This article presents a decision‐making framework towards this intent for strengthening the existing government primary healthcare network. In this article, a mixed‐integer linear programing (MILP) model is developed for optimal reconfiguration of the existing government primary healthcare network to minimise patient out‐of‐pocket expenditures (OOPE). The model involves three types of facilities: Primary Health Centre (PHC), Community Health Centre (CHC), and Private OPD (outpatient department). Implementation of the proposed model can help in reducing out‐of‐pocket expenditures. The optimization model proposed in the article is unique as it incorporates for the first time, patient out‐of‐pocket expenditure, capacity reconfiguration, and public‐private partnership decisions in the primary healthcare system. A solution algorithm is also proposed for the optimization model. The model would be useful for theory development and also in policy‐making.

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“…Community feel many advantages about the importance of medical insurance coverage (Dang et al, 2021). The main benefit is that keeping a limited number of assets in the form of money held by paying guarantees security.…”

Section: Understanding Public Health Insurancementioning

confidence: 99%

Understanding of the health insurance program in the perspective of human rights in Indonesia

Manullang

2022

ijhs

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This paper discusses the public's understanding of the health insurance program from the perspective of human rights in Indonesia. The author believes that the public needs to understand the health insurance program from the point of view of law and human rights as citizens living in Indonesia and democracy. A series of data searches on some insurance and health literature databases were reviewed from a legal perspective. The data that has been collected is then analyzed under a phenomenological approach, a study model that seeks to understand a phenomenon that exists in a context to be described and studied for re-understanding. The data search was carried out by keyword on the Google Scholar search engine in many publications published from 2010 to 2022. Based on the data and research results, we believe that all of these have met the requirements for validity and accuracy of the data to answer the problem. The results, among others, are that based on regulatory law number 24 of 2011, every citizen has the right to get assistance in health and social insurance like life insurance from the state.

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Importance of Evidence-Based Health Insurance Reimbursement and Health Technology Assessment for Achieving Universal Health Coverage and Improved Access to Health in India

Cited by 23 publications

References 24 publications

Ensuring quality in contextualised cancer management guidelines for resource-constraint settings: using a systematic approach

Ensuring quality in contextualised cancer management guidelines for resource-constraint settings: using a systematic approach

A public‐private partnership based model for regulating out‐of‐pocket expenditures to strengthen primary care system

Understanding of the health insurance program in the perspective of human rights in Indonesia

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