scholarly journals INVESTIGATION OF POSSIBLE ORGANIZATIONAL CHANGES TO THE HEALTH INSURANCE SYSTEM IN VIETNAM

2021 ◽  
Author(s):  
Mai Thi DOAN ◽  
Sergey I. DUKHNO
Keyword(s):  
Health Insurance ◽  
Cultural Values ◽  
Population Aging ◽  
The Elderly ◽  
Type Model ◽  
Health Insurance System ◽  
Organizational Changes ◽  
Insurance System ◽  
Asian Society ◽  
The Government

Purpose – to identify the prerequisites for organizational changes of the emerging health insurance system in Vietnam. Research methodology - comparative analysis, statistical analysis, case study. Findings – the obligatory health insurance in Vietnam performs its functions only partially. There is still high level of out-of-pocket spending on medical services. First we identified one of the most important challenges to the health insurance system in Vietnam, namely, the population aging. Secondly, we identified and analyzed and the prerequisites (the pre-existing conditions), which can become the basis for the reorganization of the existing health insurance system without major reforms: (1) the cultural values of Asian society, which allow to build a community-based type model of living for the elderly on the basis of “equal with equal”; (2) technological advances in medicine that extend the healthy life of the elderly, (3) trust in traditional medicine, which allows widen the coverage of the poorest “elderly households”. Practical implications - the results of the study require attention from the government and insurance providers when rethinking of organizing process for mandatory medical insurance. Originality/Value – we have identified the ways of possible organizational changes for the health insurance system, making the most of the existing prerequisites. This can help to get closer to the goal of full coverage with health insurance services while achieving a positive social effect. The identified internal reserves make it possible to imple- ment organizational changes without major reforms of the established health insurance system. No studies have been conducted in this perspective.

Triptans use and overuse: A pharmacoepidemiology study from the French health insurance system database covering 4.1 million people

Cephalalgia ◽  
2015 ◽  
Vol 35 (13) ◽  
pp. 1172-1180 ◽  
Author(s):  
David Braunstein ◽  
Anne Donnet ◽  
Vincent Pradel ◽  
Vincent Sciortino ◽  
Véronique Allaria-Lapierre ◽  
...  
Keyword(s):  
Health Insurance ◽  
The Elderly ◽  
Migraine Treatment ◽  
Health Insurance System ◽  
Insurance System ◽  
Defined Daily Doses ◽  
Gender And Age ◽  
Appropriate Prescribing ◽  
Reimbursement Database ◽  
Triptan Overuse

Introduction The objective of this study was to estimate and to characterize the actual patterns of triptan use and overuse in France using a drug reimbursement database. Methods We included all people covered by the French General Health Insurance System (GHIS) from the Provence-Alpes-Côte-d’Azur (PACA) and Corsica administrative areas who had at least one dispensed dose of triptans between May 2010 and December 2011. All dispensed doses of triptans, migraine prophylactic treatment and psychotropic medications were extracted from the GHIS database. Triptan overuse was defined as triptan use >20 defined daily doses (DDD) per month on a regular basis for more than three consecutive months. Risk of overuse was assessed using logistic regression adjusted for gender and age. Results We included 99,540 patients who had at least one prescription of a triptan over the 20 months of the study. Among them, 2243 patients (2.3%) were identified as overusers and received 20.2% of the total DDD prescribed. Twelve percent of overusers and 6.9% of non-overusers were aged more than 65 years (OR: 1.81). Overusers did not have a greater number of prescribers and pharmacists than non-overusers. They were more frequently prescribed a prophylactic medication for migraine treatment (56.8% vs 35.9%, OR: 2.36), benzodiazepines (69.9% vs 54.7%, OR: 1.93) and antidepressants (49.4% vs 30.2%, OR: 2.33). Conclusions This work suggests that triptan overuse may be due to insufficient prescriber awareness of appropriate prescribing. The off-label prescription of triptans among the elderly necessitates investigating their cardiovascular risk profile in this sub-group.

scholarly journals Structural and Regional Characteristics and Cost Efficiencies in the Local Public Health Insurance System: Empirical Evidence from the Japanese National Health Insurance System

2016 ◽  
Vol 2 (2) ◽  
pp. 262
Author(s):  
Michio Yuda
Keyword(s):  
Adverse Effect ◽  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Care Systems ◽  
The Elderly ◽  
Health Insurance System ◽  
Insurance System ◽  
Care Systems

<p><em>In this study, I use panel data from municipal Japanese National Health Insurance (JNHI) insurers to estimate their financial efficiency scores using nonparametric methods and to estimate the causal effects of structural and regional characteristics on the efficiency scores consistently using econometric methods. The major findings of this study are as follows. First, the estimated efficiency scores imply that many JNHI insurers have serious financial inefficiencies, and that total cost efficiency (economic efficiency) is strongly and positively correlated with allocative efficiency. Second, the empirical results of the effects of various factors on efficiency scores indicate that the two major policy reforms for health care systems for the elderly in 2008 contribute strongly to the improvement of JNHI insurers’ finances. Third, the subsidy from a prefectural government positively affects efficiencies, but subsidies from central and municipal governments have an adverse effect. Fourth, contributions to health care systems for the elderly still have an adverse effect on JNHI finances.</em></p>

The Determinants of Long-Term Care Utilization and Equity of Access to Care among Older Adults in Dong-Ku of Incheon Metropolitan City, South Korea

2005 ◽  
Vol 17 (2) ◽  
pp. 104-109 ◽  
Author(s):  
J.M. Park
Keyword(s):  
Health Insurance ◽  
Long Term Care ◽  
The Elderly ◽  
Care Utilization ◽  
Universal Health Insurance ◽  
Health Insurance System ◽  
Term Care ◽  
Insurance System ◽  
Universal Health

Under the current health care system, around three percent of the elderly remain uninsured. Based on the 2003 Dong-Ku Health Status Survey and the Aday and Andersen Access Framework, the present study examined the social and behavioral determinants of long-term care utilization and the extent to which equity in the use of long-term care services for the elderly has been achieved. The results indicate that universal health insurance system has not yielded a fully equitable distribution of services. Type of coverage and resource availability do not remain predictors of long-term care utilization. The data suggest that a universal health insurance system exists in South Korea with significant access problems for the population without insurance. Access differences also arise from obstacles in expanding the scope and level of plan benefits due to financial disparity among insurers. Health policy reforms must continue to concentrate on extending insurance coverage to the uninsured and establishing long-term insurance system for the elderly. Asia Pac J Public Health 2005; 17(2): 104-109.

OPPORTUNITIES TO INTEGRATE IN BULGARIA THE BEST PRACTICES FROM THE USA MODEL OF PRIVATE ENTERPRENEURSHIP HEALTH INSURANCE SYSTEM

2018 ◽  
Vol 28 (1) ◽  
pp. 183-188
Author(s):  
Yordanka Tasheva
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Private Insurance ◽  
Insurance Companies ◽  
Health Insurance System ◽  
Insurance System ◽  
Medical Care Costs ◽  
The Usa ◽  
The Government ◽  
Bulgarian Population

The USA health insurance system is a model that encourages the entrepreneurship development in all kinds of medical care. The problems in USA and partly in Bulgaria concern the big difference between the actual medical care costs and the payment from the health insurance system. The private insurance companies are different in any USA state. In Bulgaria the private insurance companies must be limited and it is necessary to be integrated a central insurance system for the Bulgarian population. It must be controlled by the government state. In Bulgaria must be only one insurance government company and the population shouldn’t be divided as poor or rich, or employed or unemployed. In the present conditions the private insurance companies cannot be controlled by the Bulgarian government by giving any advices about the investments, saved by the played population health care insurances.

scholarly journals IMPLEMENTASI KEBIJAKAN TATAKELOLA PESERTA PROGRAM JAMINAN KESEHATAN NASIONAL DI JATIM

2016 ◽  
Vol 2 (01) ◽  
Author(s):  
M. Ali Imron Rosyadi
Keyword(s):  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Poor People ◽  
Care Seeking ◽  
Health Insurance System ◽  
Insurance System ◽  
Insurance Program ◽  
Health Insurance Program ◽  
The Government

Health insurance system is one of the important components in ensuring theneeds of basic human rights, namely health. Government as theimplementing regulations in the fulfillment of basic rights such as healthhave been doing the development, guidance, and acceleration in organizinghealth care. So that the government is very strategic role in theimplementation of the National Health Insurance program (JKN). But thereis one problem JKN program implementation, namely the weakmanagement of the participants. It affects both services and financing JKNprogram. There have been several studies that analyze these problems,among others, the study of health care seeking behavior of participants ofpublic health insurance, the readiness of stakeholders in the implementationof JKN, and the program participant data JKN invalid and not targeted. Sothat in this research conducted a study which aims to analyze themanagement of participants through the method of interpretation, describe,analyze, and the build a model of the implementation of managementpolicies of insured people, and the synchronization of the health insuranceprogram regional level into the health insurance system nationwidemanaged by BPJS Health in the Province of East Java. The results showedthat participants in the program management JKN is not optimal, andcurrently poor people who can not be accommodated in the management ofContribution Recipient (PBI) has been well managed by the regionalgovernment, through the Regional Health Insurance program. Further theparticipant management implementation model is not effective as a modelof policy implementation of Van Metter and Van Horn due to weakoversight of the bureaucratic system and the human resources involved inthe implementation of the management of the participants. Keywords : Implementation of policy, National Health Insurance (JKN), management of participants.

scholarly journals Moving Towards Universal Health Coverage

2018 ◽  
pp. 19-45
Author(s):  
Ching Yuen Luk
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Social Health Insurance ◽  
Social Health ◽  
Health Coverage ◽  
Health Insurance System ◽  
Insurance System ◽  
Social Health Insurance System ◽  
The Government ◽  
Universal Health

This study uses a refined version of historical institutionalism to critically examine the complex interplay of forces that shape the health insurance reform trajectory in China since the mid-1980s and identifies problems that impede the government from achieving universal health coverage (UHC). It shows that China's multi-layered social health insurance system has covered more than 95 percent of its population, but failed to provide insured people with access to a range of essential services and make health care affordable. To achieve UHC, the government has to overcome significant hurdles, which include the inherently discriminatory design of the social health insurance system, disorder in the drug distribution system, deficits in the funding of health insurance, and insufficient medical protection for the old people.

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