scholarly journals Improving the Formation of the Kazakhstan National Drug Formulary to Increase the Rational Use of Medicines

2020 ◽  
Vol 2 (37) ◽  
pp. 43-59
Author(s):  
Gulzira Zhussupova ◽  
◽  
Didar Baidullayeva ◽  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Social Health Insurance ◽  
Social Health ◽  
Policy Options ◽  
Drug Formulary ◽  
Rational Use ◽  
Rational Use Of Medicines ◽  
National Drug

Abstract Kazakhstan national drug formulary form is defined as - a list of medicines with proven clinical safety and efficacy, as well as orphan (rare) drugs, which is a mandatory basis for the development of medicinal formularies of medical organizations and formation of lists of procurement of medicines within the guaranteed volume of free medical care and in the system of compulsory social health insurance in the Code “On public health and health care system”. Health research data show that in 18% of cases, non-KNF drugs were prescribed in Nur-Sultan medical organizations, 86% of healthcare organizations did not analyze rational use of financial costs for medicines and analyzes of drug consumption, 90% of medicines are assigned by trade name. At the same time, polypharmacy, excessive prescription of antibiotics and injection drugs are noted. The lack of a systematic understanding of the role of CNF in the rational use of drugs reduces the effectiveness of the measures taken. The value of the Kazakhstan National Drug Formulary for the health care of the Republic of Kazakhstan is enormous, for example, for clinicians it is a public resource for doctors and serves as a reference book on medicines and pharmacotherapy based on evidence-based medicine, as well as a guide to integrate Kazakhstan's usual clinical practice into international best practice, in addition to educational a guide providing continuing education in clinical pharmacology and a restrictive list of drugs recommended for routine use in routine clinical practice. For the population, it plays the role of a guideline in the provision of medicines within the guaranteed volume of medical care and in the system of compulsory social health insurance, as well as guidance on involving civil society in the process of monitoring the rational use of medicines. This policy brief shows three policy options and visions for implementing policy options. At the same time, the existing legislative framework of Kazakhstan has all the necessary conditions to support the implementation of the proposed policy options, however, the main barriers to the implementation of policy options may be a lack of human resources, unethical promotion of medicines on the market, lack of support from the authorized body in the field of health, and there is also a lack of understanding by medical workers and the public of the role of the Kazakhstan national formulary in the rational use of medicines.

Considering Spirituality in Occupational Therapy Practice

1994 ◽  
Vol 61 (2) ◽  
pp. 95-101 ◽  
Author(s):  
Mary Egan ◽  
M. Denise Delaat
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Occupational Therapy ◽  
Occupational Therapists ◽  
Occupational Performance ◽  
Exact Role ◽  
Therapy Guidelines

Despite its prominent place in the Occupational Therapy Guidelines for client-centred practice, the exact role of spirituality in clinical practice has been difficult to delineate. In this paper current concepts of spirituality are outlined and ways in which these concepts have been applied in health care are described. To illustrate these spiritual concepts, the experiences of individuals whom the authors have met in their clinical practice are outlined in a series of vignettes. Finally, a revision of the model of occupational performance which enhances consideration of spirituality in occupational therapy practice is proposed, and some guidelines for occupational therapists wishing to incorporate spiritual concerns in therapy are suggested.

Montenegro

2021 ◽  
pp. 929-938
Author(s):  
Natalija Perišić
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Healthcare Delivery ◽  
Social Health Insurance ◽  
Social Health ◽  
Healthcare Provision ◽  
Health Politics ◽  
Private Healthcare ◽  
Incomplete Coverage

This chapter examines health politics and the health system in Montenegro based on compulsory social health insurance. It traces the post-communist development of the Montenegrin healthcare system that started with incremental privatization and continued toward a more decisive move toward liberalization through the 2004 reforms, which included, among other elements, a stronger role of private healthcare delivery and the introduction of different types of voluntary insurance. As the chapter notes, the main issues facing the health system in Montenegro are incomplete coverage, limited access to healthcare, and lack of regulation of private healthcare provision.

scholarly journals Impacts of the type of social health insurance on health service utilisation and expenditures: implications for a unified system in China

2018 ◽  
Vol 14 (4) ◽  
pp. 468-486 ◽  
Author(s):  
Si Ying Tan ◽  
Xun Wu ◽  
Wei Yang
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
Rapid Expansion ◽  
Social Health ◽  
Service Utilisation ◽  
Provider Payment ◽  
Out Of Pocket Payments ◽  
The Impact

AbstractWhile moving towards unified social health insurance (SHI) is often a politically popular policy reform in countries where rapid expansion in health insurance coverage has given rise to the segmentation of SHI systems as different SHI schemes were rolled out to serve different populations, the potential impacts of reform on service utilisation and health costs have not been systematically studied. Using data from the Chinese Health and Retirement Longitudinal Study (CHARLS), we compared the mean costs incurred for both inpatient and outpatient care under different health insurance schemes, and the impact of different SHI schemes on treatment utilisation and health care costs using a two-part model. Our results show that Urban Employee Medical Insurance, which offers the most generous benefits, incurs the highest total costs prior to reimbursement when compared to other SHI schemes. Our analysis also shows that utilisation of SHI did not show significant reduction in out-of-pocket payments for outpatients. We argue that, unless effective measures are introduced to deal with perverse provider payment incentives, the move towards a unified system with more generous benefits may usher in a new wave of cost escalation for health care systems in China.

scholarly journals Factors Affecting Enrollment in Government Health Insurance Program in Kailali District

2019 ◽  
Vol 17 (3) ◽  
pp. 388-393
Author(s):  
Deepak Raj Paudel
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Illness ◽  
Social Health Insurance ◽  
Social Health ◽  
Factors Affecting ◽  
Government Health ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Insurance Enrollment

Background: Health care financial burden on households is high in Nepal. High health care expenditure is a major obstacle in achieving universal health coverage. The health insurance is expected to reduce healthcare expenditure. However, only small segments of the population are covered by health insurance in Nepal.This study assessed the factors affecting enrollment in government health insurance program in the first piloted district, Kailali, Nepal.Methods: A cross-sectional survey was conducted among 1048 households located in 26 wards of Kailali district after 21 months of the implementation of social health insurance program, Nepal. The sample was selected in two stages, first stage being the selection of wards and second, being the households.Results: The higher level of household economic status was associated with increased odds of enrollment in health insurance program (ORs=4.99, 5.04, 5.13, 8.05, for second, third, fourth, and the highest quintile of households, respectively). A higher level of head’s education was associated with increased odds of health insurance enrollment (ORs = 1.58, 1.78, 2.36, for primary, secondary, tertiary education, respectively). Presence of chronic illness in the household was positively associated with increased odds of health insurance enrollment (OR= 1.29). Conclusions: The poor and low educated groups were less benefited by social health insurance program in Kailali district, Nepal. Hence, policymakers should focus to implement income-based premium scheme for ensuring equal access to healthcare.Since household with chronic illness leads to high odds of being enrolled, a compulsory health insurance scheme can make the program financially sustainable.Keywords: Enrollment; health expenditure; health insurance; inequality; Nepal.

scholarly journals Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Abel Mekonne ◽  
Benyam Seifu ◽  
Chernet Hailu ◽  
Alemayehu Atomsa
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Health Professionals ◽  
Addis Ababa ◽  
Social Health Insurance ◽  
Social Health ◽  
Care Providers ◽  
The Government

Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.

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