The Effect of Health Transformation Plan on Out-of-Pocket Payments of the Hospitalized Patients in Hamedan, Iran

Background: Out-of-Pocket (OOP) payment is categorized among the critical indicators of health system financing. Given the high hospitalization costs of the hospitals, the ministry of health has attempted to implement Health Transformation Plan (HTP) in Iran to reduce OOP. The purpose of this paper is to show the effects of HTP on OOP payments of the hospitalized patients in Hamedan, Iran. Methods: This descriptive-analytical study was carried out on 587 patients in the educational hospitals of Hamedan. The data obtained before and after implementing the HTP was from 2013 to 2015. Data analysis was performed using SPSS16. Results: In this study, each patient's expenditures increased by 32.2 % in 2015, compared to before the implementation of the HTP. Therefore, the health insurance organization's coverage of OOP payments decreased to 8.3 % of the total costs by a 20.2 % reduction in 2015, compared to before the implementation of the plan. Conclusion: According to the study, HTP and government health subsidies were adequate, but the total hospitalization costs had an upward trend in all funds.

The evolution of the financial and organizational aspects of health infrastructure development: The national and regional level perspectives

Subject. This article considers the stages of development of the Russian healthcare infrastructure. Objectives. The article aims to highlight the sustainable trends of the development of the multi-level public and market healthcare system in Russia at the turn of the 20th and 21st centuries in terms of financial and organizational support. The article also intends to consider the prospects for the development of the Russian healthcare system. Methods. For the study, we used the methods of the evolution theory, economics, statistical, and structural analyses, and the expert assessment approach. Results. The article presents an evolutionary model of the health system financing in Russia. It describes the prospects for the development of Russian healthcare in the context of creating a digital single circuit built on the network interaction of regional digital platforms. Conclusions. Creating a regional digital platform based on next-generation smart information systems will help improve the quality of healthcare delivery and the level of health investment.

A framework for explaining the role of values in health policy decision-making in Latin America: a critical interpretive synthesis

Background Although values underpin the goals pursued in health systems, including how health systems benefit the population, it is often not clear how values are incorporated into policy decision-making about health systems. The challenge is to encompass social/citizen values, health system goals, and financial realities and to incorporate them into the policy-making process. This is a challenge for all health systems and of particular importance for Latin American (LA) countries. Our objective was to understand how and under what conditions societal values inform decisions about health system financing in LA countries. Methods A critical interpretive synthesis approach was utilised for this work. We searched 17 databases in December 2016 to identify articles written in English, Spanish or Portuguese that focus on values that inform the policy process for health system financing in LA countries at the macro and meso levels. Two reviewers independently screened records and assessed them for inclusion. One researcher conceptually mapped the included articles, created structured summaries of key findings from each, and selected a purposive sample of articles to thematically synthesise the results across the domains of agenda-setting/prioritisation, policy development and implementation. Results We identified 5925 references, included 199 papers, and synthesised 68 papers. We identified 116 values and developed a framework to explain how values have been used to inform policy decisions about financing in LA countries. This framework has four categories – (1) goal-related values (i.e. guiding principles of the health system); (2) technical values (those incorporated into the instruments adopted by policy-makers to ensure a sustainable and efficient health system); (3) governance values (those applied in the policy process to ensure a transparent and accountable process of decision-making); and (4) situational values (a broad category of values that represent competing strategies to make decisions in the health systems, their influence varying according to the four factors). Conclusions It is an effort to consolidate and explain how different social values are considered and how they support policy decision-making about health system financing. This can help policy-makers to explicitly incorporate values into the policy process and understand how values are supporting the achievement of policy goals in health system financing. Trial registration The protocol was registered with PROSPERO, ID=CRD42017057049.

Health economics for psychiatric epidemiology

This chapter examines the interface between psychiatric epidemiology and health economics, particularly in relation to mental health service planning and evaluation. It describes examples of how economics and epidemiology work together to produce innovative research approaches from basics such as burden of disease and cost-of-illness studies to more complex approaches such as the assessment of mental health system financing and economic evaluation of mental healthcare interventions. It rounds up with a summary of how to conduct economic evaluations, including sections on study design, mode of economic evaluation, and costing perspective.

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

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.

The efficiency of the healthcare systems in EU countries – A DEA analysis

The objective of this paper is to identify the most efficient healthcare systems in a sample of 17 EU Member States. According to the health system financing schemes, the selected countries belong to two main groups, Beveridge and Bismarck. The research includes five input variables describing the financial and human resources, the level of health infrastructure, the medical technology and the healthcare utilization. On the output side we analysed four measures that reflect the overall health status of the population and the effectiveness of prevention and emergency care. Using the Data Envelopment Analysis (DEA) method, the most efficient healthcare systems are found in Sweden, the UK and Romania. The constraints applied for all the indicators and scenarios lead to higher or lower inefficiency scores, the Beveridge group being on average more efficient than the Bismarck one.

Trends in healthcare costs in Serbia

Healthcare system has an important role in the contemporary countries' economic development. Health expenditures are affected by many economic, as well as noneconomic factors. The importance of health and health system financing is particularly evident in the circumstances of the COVID-19 coronavirus pandemic, which caused a significant increase in unforeseen heath expenditures, as well as the emergence of fiscal deficit in many countries around the world. The purpose of this paper is to provide insight into the trend of the most important health spending indicators in Serbia in the period from 2012 to 2017. The paper concludes that in addition to the reform of the national health financing system, the Serbian Government should implement austerity measures to make health expenditures more sustainable.

The Relationships and Configuration of Universal and Optional Healthcare Financing Schemes in Czechia

In developed countries, both universal and optional parts of healthcare exist. This article shows the importance and fiscal position of universally available care and suggests where it can be extended by optional financing schemes such as prepaid health programmes. We use a comparative approach, SWOT analysis and synthesis of individual mechanisms of health financing into a single health system. A simple scheme of possible health system financing configuration is created, and we classify the financial resources and schemes used accordingly. Overall this article introduces a theoretically substantiated overview of health policy options for Czechia based on principles of universally available care, solidarity, fiscal neutrality, adequate fiscal space for health and voluntary private health expenditure.