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health care financing

Linn Kullberg, Paula Blomqvist, Ulrika Winblad
BACKGROUND: Health care provision in rural and urban areas faces different challenges. In Sweden, health care provision has been predominantly public and equitable access to care has been pursued mainly through public planning and coordination. This is to ensure that health needs are met in the same manner in all parts of the country, including rural or less affluent areas. However, a marketization of the health care system has taken place during recent decades and the publicly planned system has been partially replaced by a new market logic, where private providers guided by financial concerns can decide independently where to establish their practices...
August 17, 2018: International Journal for Equity in Health
Zawora Rita Zizien, Catherine Korachais, Philippe Compaoré, Valéry Ridde, Vincent De Brouwere
In response to the poor performance of its public health care provision, Burkina Faso decided, to implement results-based financing (RBF). This strategy relies on a strategic purchase of the quantity and quality of services provided by health workers, monitored by a set of indicators. However, there is a lack of evidence on its effects. The objective of this article is to appreciate the effect of RBF on a set of maternal and child health (MCH) indicators in Burkina Faso. The study design is quasi-experimental comparative with a control group before and after the implementation of the RBF...
August 16, 2018: International Journal of Health Planning and Management
Paibul Suriyawongpaisal, Samrit Srithamrongsawad, Pongsakorn Atiksawedparit, Khanisthar Phooseemungkun, Krongkan Bunchaiyai, Thanita Thongtan
Introduction: Financing health systems constitutes a key element of well-functioning healthcare system. Prior to 2015, two new financial arrangements (direct-pay and E-claim systems) were introduced on a voluntary basis which aimed to pool more financial resources and improve cash flow of prehospital care systems. The aims of this study were to (1) assess the effects of direct-pay system in terms of (a) timeliness of reimbursement to EMS agencies, (b) changes in clinical care processes, and (c) the outcomes of patient care as compared to previous system; (2) identify the reasons for or against EMS agencies to participate in direct-pay system mechanisms; (3) identify the emerging issues with potential to significantly further the advancement of EMS systems...
2018: Emergency Medicine International
Elina Miteniece, Milena Pavlova, Lela Shengelia, Bernd Rechel, Wim Groot
BACKGROUND: The maternal health outcomes in Georgia are linked to shortcomings in healthcare such as inequities in access to adequate maternal care. Due to the macro-level, quantitative approach applied in most previous studies, little is known about the underlying reasons that influence maternal care and care-seeking behaviour of pregnant women. METHODS: This qualitative study explores the stakeholders' perspectives on access to adequate maternal care in Georgia...
August 13, 2018: BMC Health Services Research
Cecilia Brain, Steven Kymes, Dana B DiBenedetti, Thomas Brevig, Dawn I Velligan
BACKGROUND: Treatment-resistant schizophrenia (TRS) affects about one-third of individuals with schizophrenia. People with TRS do not experience sustained symptom relief and at the same time have the most severe disease-related disability and associated costs among individuals with severe mental disorders. Like caregivers of people with treatment-responsive schizophrenia, caregivers of individuals with TRS experience the disease burden along with their care recipients; however, for those providing care for individuals with TRS, the stress of the burden is unrelenting due to uncontrolled symptoms and a lack of effective treatment options...
August 13, 2018: BMC Psychiatry
Jessica Liang, Stephanie J Lee, Barry E Storer, Bronwen E Shaw, Eric J Chow, Mary E Flowers, Elizabeth F Krakow, Merav Bar, Karen L Syrjala, Rachel B Salit, Chareeni E Kurukulasuriya, Heather S L Jim
BACKGROUND: Hematopoietic cell transplant (HCT) can cause significant distress in patients and their informal caregivers. Despite advances in reduced intensity conditioning and supportive care, few recent studies have reported rates of clinically-significant post-traumatic stress disorder symptomatology (hereafter referred to as PTSD). Goals of the current study were to: 1) examine rates of PTSD and distress in patients and caregivers and 2) identify sociodemographic and clinical risk factors for PTSD...
August 8, 2018: Biology of Blood and Marrow Transplantation
Anthony Harris, Anurag Sharma
AIMS: We estimate the pure effect of ageing on total health and aged care expenditure in Australia in the next 20 years. METHODS: We use a simple demographic projection model for the number of people in older age groups along with a needs based estimate of changes in the public and private cost of care per person in each group adjusted for expected changes in morbidity. RESULTS: A pure ageing model of expenditure growth predicts an increase in health expenditure per elderly person from $7439 in 2015 to $9594 in 2035 and an increase in total expenditure from $166 billion to $320 billion (an average annual growth of 3...
2018: PloS One
Abdur Razzaque Sarker, Marufa Sultana, Nausad Ali, Raisul Akram, Nurnabi Sheikh, Rashidul Alam Mahumud, Alec Morton
OBJECTIVES: The objective of this study is to capture the relevant out-of-pocket (OOP) costs, coping mechanisms, and associated factors that are related to child delivery in Bangladesh through the use of nationwide household level data. DATA AND METHODS: The study was conducted using a secondary data source of the latest Bangladesh Demographic and Health Survey 2014. A cross-sectional survey was performed for 6 months, from June to November 2014, where closed-ended questions regarding child delivery-related expenditure were included...
August 9, 2018: International Journal of Health Planning and Management
Chhabi Lal Ranabhat, Myung-Bae Park, Chun-Bae Kim, Chang-Soo Kim, Hyoung-Sun Jeong, Sang Baek Koh, Sei-Jin Chang
Background: Adult mortality is associated with different demographic and behavioral risk factors including approaches to health care financing. Adult mortality rate significantly reflects the effectiveness of public health-related program and intervention. The aim of this study was to find strength of association between key health's related indicators and adult mortality rate. Methods: This cross-sectional study used 5 sets of data combined into one from different organizations of 193 countries using record linkage theory...
June 2018: Iranian Journal of Public Health
Musah Khalid, John Serieux
Ghana introduced a social health insurance scheme in 2003. One of its motivations was to protect consumers against adverse health shocks. Financing for the programme comes from a 2.5% goods and service tax, contributions by formal sector workers directly transferred from their social security savings and individual premiums from informal members. This arrangement makes formal workers compulsory members of the scheme while informal members voluntarily enroll. We view this as a natural experiment in which one section of the population automatically acquires insurance (with formal sector employment), and the remainder choose to obtain the same coverage (or not)...
August 3, 2018: Health Policy and Planning
Andrew D Carlo, Jürgen Unützer, Anna D H Ratzliff, Joseph M Cerimele
Purpose of Review: Collaborative care (CoCM) is an evidence-based model for the treatment of common mental health conditions in the primary care setting. Its workflow encourages systematic communication among clinicians outside of face-to-face patient encounters, which has posed financial challenges in traditional fee-for-service reimbursement environments. Recent Findings: Organizations have employed various financing strategies to promote CoCM sustainability, including external grants, alternate payment model contracts with specific payers and the use of billing codes for individual components of CoCM...
September 2018: Current Treatment Options in Psychiatry
Liana E Chase, Kedar Marahatta, Kripa Sidgel, Sujan Shrestha, Kamal Gautam, Nagendra P Luitel, Bhogendra Raj Dotel, Reuben Samuel
Background: The World Health Organization's 'building back better' approach advocates capitalizing on the resources and political will elicited by disasters to strengthen national mental health systems. This study explores the contributions of the response to the 2015 earthquake in Nepal to sustainable mental health system reform. Methods: We systematically reviewed grey literature on the mental health and psychosocial response to the earthquake obtained through online information-sharing platforms and response coordinators (168 documents) to extract data on response stakeholders and activities...
2018: International Journal of Mental Health Systems
Anna T Höglund, Erica Falkenström
BACKGROUND: By tradition, the Swedish health care system is based on a representative and parliamentary form of government. Recently, new management forms, inspired by market principles, have developed. The steering system is both national and regional, in that self-governing county councils are responsible for the financing and provision of health care in different regions. National and local documents regulating Swedish health care mention several ethical values, such as equity in health for the whole population and respect for autonomy and human dignity...
August 6, 2018: BMC Health Services Research
Hubert Amu, Kwamena Sekyi Dickson, Akwasi Kumi-Kyereme, Eugene Kofuor Maafo Darteh
BACKGROUND: Realisation of universal health coverage is not possible without health financing systems that ensure financial risk protection. To ensure this, some African countries have instituted health insurance schemes as venues for ensuring universal access to health care for their populace. In this paper, we examined variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania. METHODS: We used data from demographic and health surveys of Ghana (2014), Kenya (2014), Nigeria (2013), and Tanzania (2015)...
2018: PloS One
Len M Nichols, Lauren A Taylor
Good research evidence exists to suggest that social determinants of health, including access to housing, nutrition, and transportation, can influence health outcomes and health care use for vulnerable populations. Yet adequate, sustainable financing for interventions that improve social determinants of health has eluded most if not all US communities. This article argues that underinvestment in social determinants of health stems from the fact that such investments are in effect public goods, and thus benefits cannot be efficiently limited to those who pay for them-which makes it more difficult to capture return on investment...
August 2018: Health Affairs
Léon Jules Owona Manga, André Arsène Bita Fouda, Lucien Mbida, Come Ebana Mvogo
The performance based financing approach is being tested in four regions of Cameroon, including the Littoral region. Our study aimed to study the effects associated with the implementation of the performance based financing approach within the health facilities based in the health district of Edea in the Littoral region in Cameroon. We've carried out a crosssectional analytical study among 178 health personnel from 21 health facilities under PBF-contract within the health district of Edea. We have studied their sociodemographic characteristics, the individual and collective effects resulting from the performance based financing subsidies and the level of job satisfaction...
May 21, 2018: Journal of Public Health in Africa
Kafayat Oboirien, Bronwyn Harris, Jane Goudge, John Eyles
BACKGROUND: Improving the quality of health care is a national priority in many countries to help reduce unacceptable levels of variation in health system practices, performance and outcomes. In 2012, South Africa introduced district-based clinical specialist teams (DCSTs) to enhance clinical governance at the lowest level of the health system. This paper examines the expectations and responses of local health system actors in the introduction and early implementation of this new DCST role...
August 3, 2018: BMC Health Services Research
Chukwuemeka A Umeh
Although many sub-Saharan African countries have made efforts to provide universal health coverage (UHC) for their citizens, several of these initiatives have achieved little success. This study aims to review the challenges facing UHC in Ghana, Kenya, Nigeria, and Tanzania, and to suggest program or policy changes that might bolster UHC. Routine data reported by the World Bank and World Health Organization, as well as annual reports of the national health insurance schemes of Ghana, Kenya, Nigeria, and Tanzania, were analyzed...
August 3, 2018: International Journal of Health Planning and Management
Rahab Mbau, Edwine Barasa, Kenneth Munge, Stephen Mulupi, Peter K Nguhiu, Jane Chuma
BACKGROUND: Purchasing in health care financing refers to the transfer of pooled funds to health care providers for the provision of health care services. There is limited empirical work on purchasing arrangements and what is required for strategic purchasing in low- and middle-income countries. We conducted this study to critically assess the purchasing arrangements of the county departments of health (CDOH) who are the largest purchasers of health care in Kenya. METHODS: We used a qualitative case study approach to assess the extent to which the purchasing actions of the CDOH in Kenya were strategic...
August 3, 2018: International Journal of Health Planning and Management
Abdur Razzaque Sarker, Marufa Sultana, Sayem Ahmed, Rashidul Alam Mahumud, Alec Morton, Jahangir A M Khan
Background : Community-based health insurance is recognized as a promising tool for health system improvement for low-income people that improves the health status of enrolees and enhances productivity and labor supply. The experience and opinion of the clients who utilized health services through the insurance scheme are important for improving healthcare services, shaping health policies and providing feedback on the quality, availability, and responsiveness of healthcare services. However, studies focusing on clients' satisfaction provided by the health insurance scheme are still limited globally...
August 2, 2018: International Journal of Environmental Research and Public Health
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