Healthcare in Cuba: Sustainability Challenges in an Ageing System

2021 ◽  
Vol 53 (1) ◽  
pp. 133-159
Author(s):  
Carmelo Mesa-Lago ◽  
Sergio Díaz-Briquets
Keyword(s):  
Healthcare System ◽  
Health Indicators ◽  
Population Ageing ◽  
Financial Sustainability ◽  
Physical Infrastructure ◽  
Sustainability Challenges

AbstractThis article assumes a balanced position between two contrasting views regarding the accessibility, quality, efficiency and financial sustainability of the Cuban healthcare system. It evaluates those issues in the 2006–20 period by identifying strengths and weaknesses based on a comprehensive statistical compilation of health indicators, physical infrastructure trends, availability of physicians and other elements to assess the system's long-term financial sustainability. Finally, it examines the likely consequences of population ageing on healthcare, including potential policies.

scholarly journals Population ageing alongside health care spending growth

2017 ◽  
Vol 145 (9-10) ◽  
pp. 534-539 ◽  
Author(s):  
Mihajlo Jakovljevic
Keyword(s):  
Health Care ◽  
Health Expenditure ◽  
Population Ageing ◽  
Sexual Revolution ◽  
Accelerated Ageing ◽  
Financial Sustainability ◽  
Published Evidence ◽  
The Impact ◽  
Demographic Evolution

The Silver Tsunami or population ageing has become a globally widespread phenomenon. The purpose of this review is to observe its dynamics and consequences from a local Balkan perspective. The main drivers of this unique demographic evolution are extended longevity, improved early childhood survival, absorption of women into the labor markets, and consequences of sexual revolution leading to falling female fertility. This process lasting well over a century is taking its toll on contemporary societies. Major side effects are shrinking young labor force and growing pool of elderly and retired citizens in many countries. This equation tends to worsen further in the future threatening long-term financial sustainability of public social and health insurance funds. Notable health expenditure growth, accelerating worldwide since the 1960s, is to a large degree attributable to ageing itself. Growing share of senior citizens increases demand for medical services and costs of health care provision. Home-based care provided by the family caregivers presents another important reality putting a huge burden on modern communities. Serbs are no exception in this landscape. Historical demographic evolution of this nation gives a clear evidence of advanced and accelerated ageing, which is well documented in post-World War II era. This synthesis of rich published evidence shows clear upward parallel trend between the pace of population aging and the growth of health expenditure. National authorities shall be forced to consider reform of the current health care financing pattern inherited from the demographic growth era. This might be the only way to smooth out the impact of population ageing on the financial sustainability of the health system and long-term medical care in Serbia.

Financial Sustainability and Infrastructure Finance

2018 ◽  
Author(s):  
Felipe Carvalho de Rezende
Keyword(s):  
Financial Institutions ◽  
Financial Stability ◽  
Global Financial Crisis ◽  
Financial Sustainability ◽  
Infrastructure Finance ◽  
Strategic Role ◽  
Development Banks ◽  
The Global Financial Crisis ◽  
Capital Development

Among the lessons that can be drawn from the global financial crisis is that private financial institutions have failed to promote the capital development of the affected economies, and to dampen financial fragility. This chapter analyses the macroeconomic role that development banks can play in this context, not only providing long-term funding necessary to promote economic development, but also fostering financial stability. The chapter discusses, in particular, the need for public financial institutions to provide support for infrastructure and sustainable development projects. It concludes that development banks play a strategic role by funding infrastructure projects in particular, and outlines the lessons for enhancing their role as catalysts for mitigating risks associated with such projects.

scholarly journals QUANTIFICATION AND COMPARISON OF AVOIDABLE MORTALITY – CAUSAL RELATIONS AND MODIFICATION OF CONCEPTS

2015 ◽  
Vol 21 (6) ◽  
pp. 917-938 ◽  
Author(s):  
Michal SOLTES ◽  
Beata GAVUROVA
Keyword(s):  
Health Care ◽  
Healthcare System ◽  
Health Care Policy ◽  
System Efficiency ◽  
Avoidable Mortality ◽  
Care Policy ◽  
Efficient Tool ◽  
Analysis And Evaluation ◽  
General Mortality

The fundamental criticism of the analyses of relations between the allocated sources into healthcare system and general indicators of health status (represented by mortality) form a concept of avoidable mortality. The concept is a result of a reaction of many specialists in this field. The efficient concept of avoidable mortality that consists of treatable and preventable mortality components should provide prominent information that is not directly absorbed in the metrics of general mortality rate traditionally used for measuring the healthcare systems’ outputs. Permanent evaluation of the concept is based on confrontation of actual and relevant facts and supported by significant evidence from analytical outputs. This evaluation may help to form an efficient tool for measuring the amenable mortality with system connections as within health care system so in social policy, long-term health care policy, etc. The aim of this article is an analysis and evaluation of avoidable mortality development at conceptual and evaluative level and a specification of advantages and limitations that result from this concept. The analyses’ outputs represent a valuable platform for revision of strategic framework of the Slovak healthcare as well as for formation of targeted policies that focus on increase of healthcare system efficiency.

scholarly journals Cost-Effectiveness Analysis of the Daily HIV Pre-Exposure Prophylaxis in Men who Have Sex with Men in Barcelona

2021 ◽  
Author(s):  
Francesc López Seguí ◽  
Unai Oyon Lerga ◽  
Laura Laguna Marmol ◽  
Pep Coll ◽  
Angels Andreu ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Cost Saving ◽  
Time Horizon ◽  
Cost Savings ◽  
Health Indicators ◽  
Hiv Infections ◽  
Sex With Men ◽  
Exposure Prophylaxis ◽  
Oral Prep

Introduction: Pre-Exposure Prophylaxis (PrEP) for HIV prevention has been implemented in several countries. Previous literature has shown that its cost-effectiveness (and, under some specifications, cost-saving character) is dependent on the reduction in price due to generics, the time-horizon and its effectiveness. The intervention has never been studied in Catalonia, a territory with extensive implementation. Methods: Economic evaluation of the implementation of HIV pre-exposition prophylaxis using administrative data from Men who have Sex with Men (MSM) who receive the treatment (at the generic price). A deterministic compartmental model and a social perspective with a micro-costing approach over the time horizon 2022-2062 are used. A baseline 86% effectiveness of PrEP is assumed. Results: Daily oral PrEP is found to be cost-saving: discounted savings in costs are attained after 16 years, and after 40 years they reach 81 million euros. In terms of health indicators, 10,322 additional discounted QALYs are generated by the intervention. Results are sensitive to sexual behavioral patterns among MSM, the price of PrEP (reduced if offered on-demand), its effectiveness and the discount rate. Conclusions: The use and promotion of PrEP in Catalonia is predicted to result in substantial health and monetary benefits because of reductions in HIV infections. Short-term investments in the promotion of PrEP will result in important cost-savings in the long term.

OPTIONS FOR ASSESSING THE SUITABILITY OF URBAN ENVIRONMENTAL ACUPUNCTURE

2021 ◽  
Author(s):  
Barbara Vojvodíková ◽  
Jiří Kupka ◽  
Adéla Brázdová ◽  
Radim Fojtík ◽  
Iva Tichá
Keyword(s):  
Climate Change ◽  
Assessment Tool ◽  
Mitigation Measures ◽  
Small Scale ◽  
Financial Sustainability ◽  
Technical Solution ◽  
The City

To increase their resilience to climate change, cities are looking to apply elements of urban environmental acupuncture. The essence of such measures is many smaller sites that is functioning as mitigation measures. Many of these small places then create a large overall effect. The advantage of these small-scale measures is that they can be in densely populated areas The assessment tool described in this paper is designed for city representatives and is an aid to assess the suitability of applying a particular measure based on the parameters described. The evaluation itself then helps to decide whether the solution is suitable for a particular site or whether any of the parameters need to be adjusted to make it suitable, or whether it would be appropriate to change the proposed solution. The intention of the evaluation is not to assess the technical solution but relies primarily on the location, long-term (especially financial) sustainability and acceptance by the citizens of the city. The paper presents an example of the application of the evaluation to four sites in city Liptovský Mikuláš, describing the results and identifying parameters that can be improved to ensure the urban environmental acupuncture is accepted by citizens and thus future-proofed.

Sign in / Sign up

Export Citation Format

Share Document