scholarly journals Equity of health-care financing: a progressivity analysis for Egypt

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Yara Ahmed ◽  
Racha Ramadan ◽  
Mohamed Fathi Sakr
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Health Care Financing ◽  
Social Health Insurance ◽  
Financing System ◽  
Content Type ◽  
Health System Financing ◽  
The Impact ◽  
Care System

Purpose This paper aims to evaluate the progressivity of health-care financing in Egypt by assessing all five financing sources individually and then combining them to analyze the equity of the whole financing system. Design/methodology/approach Lorenz dominance analysis and Kakwani progressivity index were applied on data from 2010/2011 Household Income, Expenditure, and Consumption Survey and the National Health Accounts 2011 using Stata to evaluate the progressivity of each source of health-care finance and the financing system overall. Findings The data show that Egypt’s health-care system, which is largely financed by out-of-pocket (OOP) payments, is slightly regressive, with an overall Kakwani index of −0.079. The overall regressive effect was the result of three regressive sources (OOP payments, an earmarked cigarette tax and direct taxes), one proportional finance source (social health insurance) and two slightly progressive sources (indirect taxes and private health insurance). This shows that the burden of financing health care falls more on the poor. These results signal the need for reform of health-care financing in Egypt to reduce dependence on OOP payments to achieve more equitable financing. Originality/value The paper seeks to augment the literature on health-care financing in Egypt by calculating specific progressivity estimates for all five sources of financing the Egyptian health-care system and analyzing the overall equity of this financing system. It will, therefore, provide a benchmark for monitoring the equity of finance in the Egyptian health-care system in future studies and allow one to assess the impact of implemented financing reforms in the future on the level of progressivity of health system financing.

scholarly journals Some pain, no gain: experiences with the no-claim rebate in the Dutch health care system

2009 ◽  
Vol 4 (4) ◽  
pp. 405-424 ◽  
Author(s):  
J. HOLLAND ◽  
N.J.A. VAN EXEL ◽  
F.T. SCHUT ◽  
W.B.F. BROUWER
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Social Health Insurance ◽  
Convenience Sample ◽  
High Loss ◽  
Dutch Health ◽  
Dutch Health Care ◽  
Gp Visits ◽  
Care System

AbstractTo contain expenditures in an increasingly demand driven health care system, in 2005 a no-claim rebate was introduced in the Dutch health insurance system. Since demand-side cost sharing is a very controversial issue, the no-claim rebate was launched as a consumer friendly bonus system to reward prudent utilization of health services. Internationally, the introduction of a mandatory no-claim rebate in a social health insurance scheme is unprecedented. Consumers were entitled to an annual rebate of ₠ 255 if no claims were made. During the year, all health care expenses except for GP visits and maternity care were deducted from the rebate until the rebate became zero. In this article, we discuss the rationale of the no-claim rebate and the available evidence of its effect. Using a questionnaire in a convenience sample, we examined people’s knowledge, attitudes, and sensitivity to the incentive scheme. We find that only 4% of respondents stated that they would reduce consumption because of the no-claim rebate. Respondents also indicated that they were willing to accept a high loss of rebate in order to use a medical treatment. However, during the last month of the year many respondents seemed willing to postpone consumption until the next year in order to keep the rebate of the current year intact. A small majority of respondents considered the no-claim rebate to be unfair. Finally, we briefly discuss why in 2008 the no-claim rebate was replaced by a mandatory deductible.

Health care financing and income inequality in Nigeria

2020 ◽  
Vol 47 (11) ◽  
pp. 1419-1431
Author(s):  
Chukwuedo Susan Oburota ◽  
Olanrewaju Olaniyan
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Income Inequality ◽  
Health Care Financing ◽  
Social Health Insurance ◽  
Household Survey ◽  
Study Data ◽  
Horizontal Inequity ◽  
Content Type ◽  
High Level

PurposeThe purpose of this paper is to decompose the inequities induced by the Nigerian health care financing sources and their effect on the income distribution. Inequities in health care financing sources are of immense policy concern particularly in developing countries such as Nigeria, where high-level income inequality exists, and the cost of medical care is generally financed out-of-pocket (OOP) due to limited access to health insurance.Design/methodology/approachThe Duclos et al. decomposition model provided the theoretical framework for the study. Data were obtained from two waves of the Nigeria General Household Survey (GHS) panel, 2012–13 and 2015–16. The analysis covered 3,999 households in 2012–13 and 4,051 households in 2015–16. Two measures of health care financing: OOP payment and health insurance contribution (HIC) were used. The ability to pay measure was household consumption expenditure.FindingsThe major inequity issue induced by the OOP payments was vertical inequity. HICs created the problems of vertical inequity, horizontal inequity and reranking among households. Overall both health care financing options were associated with the worsening of income inequality both at the national and sectorial levels in the country. The operations of the NHIS need to be improved to ensuring improved health care coverage for the poor.Originality/valueThis paper fulfills an identified need to determine the income redistributive effects (REs) of the social health insurance (SHI) contribution at the national, urban and rural locations overtime.

Umverteilungseffekte in der Finanzierung von Gesundheitsleistungen / Redistribution Effects of Health Care Financing

2007 ◽  
Vol 227 (5-6) ◽  
Author(s):  
Florian Buchner ◽  
Rebecca Deppisch ◽  
Jürgen Wasem
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Systems ◽  
Health Care Financing ◽  
Social Health Insurance ◽  
Health Care Expenditures ◽  
Social Health ◽  
Financing System ◽  
Out Of Pocket Payments ◽  
Care Systems

SummaryHealth care systems are financed through a mixture of different components: taxes, contributions to social health insurance, premiums to private health insurance, out of pocket payments by patients. These components can be combined differently leading to specific effects of interpersonal redistribution. This can be compared between different countries. In such a comparison the redistributional impact of the German health care systems is rather regressive - which is basically caused by the opportunity for people with high income to leave social health insurance. In comparison to a health insurance system with risk rated premiums, financing of the German social health insurance leads to interpersonal redistribution from higher to lower income, from the young to the elderly, from healthy to sick and from singles to families with children. The pay-as-you-go character of the system leads especially in combination with an aging population and technological change to burden for future generations. In comparison to a system in which each region finances its own health care expenditures, there are also considerable interregional redistributions. The financing system in Germany is not conceptually consistent. Reform proposals (unified health insurance for all; flat rate premiums) tackle these inconsistencies.

Legal Reforms of the Polish Health Care System in View of Accessing the European Union

2001 ◽  
Vol 8 (1) ◽  
pp. 5-25 ◽  
Author(s):  
Exter
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Descriptive Analysis ◽  
Social Health Insurance ◽  
Legal Framework ◽  
State Socialism ◽  
The European Union ◽  
Advantages And Disadvantages ◽  
Care System

AbstractThe 1980s was a decade of protracted crisis within state socialism in Central and Eastern Europe, most manifestly in Poland. Poland became the trendsetter and model for change not only during the crisis of State socialism but also afterwards, during the pre-transition crisis and breakthrough from one system to another and the first period of democratic transition. Poland, therefore, experienced both the advantages and disadvantages of being a pioneer. This is for instance the case with the health care sector.This paper examines recent legislative changes in the Polish health care system. A descriptive analysis of the current legal framework identifies the main changes that have occurred since the dissolution of the socialist health system. Further research of, in particular, the new Health Insurance Act reveals several discrepancies with respect to its 'compatibility' with European Community law. Since adoption of the acquis communautaire is a prerequisite for accession, the author discusses a main acquis aspect related to social health insurance law, viz the implementation of Co-ordination Regulation 1408/71.

Private Health Care Sector in Russia:Present State and Development Prospects

2013 ◽  
pp. 94-112 ◽  
Author(s):  
S. Shishkin ◽  
E. Potapchik ◽  
E. Selezneva
Keyword(s):  
Health Care ◽  
Private Sector ◽  
Health Care System ◽  
Health Care Financing ◽  
Public Health Care ◽  
Financing System ◽  
Organic Part ◽  
The Public ◽  
Integrated Health Care System ◽  
Care System

The private sector which has emerged in the Russian health care system has become a competitor to the public one and has pulled a part of effective demand of the middle class. It has developed out of the public health care financing system. Depending on the policy of the state towards modernization of health care, the private sector can continue to grow as an alternative to the public one, but it can be a tool of modernization and an organic part of an integrated health care system.

scholarly journals Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection

2017 ◽  
Vol 61 (6) ◽  
Author(s):  
Katherine M. Shea ◽  
Athena L. V. Hobbs ◽  
Theresa C. Jaso ◽  
Jack D. Bissett ◽  
Christopher M. Cruz ◽  
...  
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Health Care System ◽  
Acquisition Cost ◽  
The United States ◽  
Content Type ◽  
Days Of Therapy ◽  
Segmented Regression Analysis ◽  
The Impact ◽  
Care System

ABSTRACT Fluoroquinolones are one of the most commonly prescribed antibiotic classes in the United States despite their association with adverse consequences, including Clostridium difficile infection (CDI). We sought to evaluate the impact of a health care system antimicrobial stewardship-initiated respiratory fluoroquinolone restriction program on utilization, appropriateness of quinolone-based therapy based on institutional guidelines, and CDI rates. After implementation, respiratory fluoroquinolone utilization decreased from a monthly mean and standard deviation (SD) of 41.0 (SD = 4.4) days of therapy (DOT) per 1,000 patient days (PD) preintervention to 21.5 (SD = 6.4) DOT/1,000 PD and 4.8 (SD = 3.6) DOT/1,000 PD posteducation and postrestriction, respectively. Using segmented regression analysis, both education (14.5 DOT/1,000 PD per month decrease; P = 0.023) and restriction (24.5 DOT/1,000 PD per month decrease; P < 0.0001) were associated with decreased utilization. In addition, the CDI rates decreased significantly (P = 0.044) from preintervention using education (3.43 cases/10,000 PD) and restriction (2.2 cases/10,000 PD). Mean monthly CDI cases/10,000 PD decreased from 4.0 (SD = 2.1) preintervention to 2.2 (SD = 1.35) postrestriction. A significant increase in appropriate respiratory fluoroquinolone use occurred postrestriction versus preintervention in patients administered at least one dose (74/130 [57%] versus 74/232 [32%]; P < 0.001), as well as in those receiving two or more doses (47/65 [72%] versus 67/191 [35%]; P < 0.001). A significant reduction in the annual acquisition cost of moxifloxacin, the formulary respiratory fluoroquinolone, was observed postrestriction compared to preintervention within the health care system ($123,882 versus $12,273; P = 0.002). Implementation of a stewardship-initiated respiratory fluoroquinolone restriction program can increase appropriate use while reducing overall utilization, acquisition cost, and CDI rates within a health care system.

scholarly journals Gabon health care system: a 20 year analysis

2017 ◽  
Vol 4 (7) ◽  
pp. 2208 ◽  
Author(s):  
Brice Wilfried Obiang Obounou
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care System ◽  
Social Health Insurance ◽  
Insurance Fund ◽  
Health Coverage ◽  
African Countries ◽  
Middle Income ◽  
The Government ◽  
Care System

In response to a high prevalence of HIV/AIDS and malaria, the government of Gabon launched the National Insurance and Social Welfare Fund in 2008. It is a national health insurance fund voted by the parliament to extend health-care coverage to the country’s different socioeconomic groups, bringing everyone under one social health insurance roof. Analysis of the WHO, World Bank and available data from 1995 to 2014 to evaluate progress before and after the creation of the universal health coverage. Maternal health is fully covered and the cost of medical care is reimbursed by 80-90%. However, out-of-pocket spending (21.87%) as a percentage of total health care spending is still higher that other Sub-Saharan African countries classified in the upper-middle income countries. The government and policy makers should increase health care system financing and work in partnership with private clinics regarding over-servicing and over billing.

scholarly journals The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System

2019 ◽  
Vol 32 (3) ◽  
pp. 362-374 ◽  
Author(s):  
Thomas F. Northrup ◽  
Kelley Carroll ◽  
Robert Suchting ◽  
Yolanda R. Villarreal ◽  
Mohammad Zare ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Safety Net ◽  
Opioid Prescribing ◽  
Urban Safety ◽  
The Impact ◽  
Care System
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