Download or read book Healthcare Financing Through Health Insurance in Kenya written by Diana N. Kimani and published by . This book was released on 2004 with total page 78 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Ghana National Health Insurance Scheme written by Huihui Wang and published by World Bank Publications. This book was released on 2017-08-14 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ghana National Health Insurance Scheme (NHIS) was established in 2003 as a major vehicle to achieve the country’s commitment of Universal Health Coverage. The government has earmarked value-added tax to finance NHIS in addition to deduction from Social Security Trust (SSNIT) and premium payment. However, the scheme has been running under deficit since 2009 due to expansion of coverage, increase in service use, and surge in expenditure. Consequently, Ghana National Health Insurance Authority (NHIA) had to reduce investment fund, borrow loans and delay claims reimbursement to providers in order to fill the gap. This study aimed to provide policy recommendations on how to improve efficiency and financial sustainability of NHIS based on health sector expenditure and NHIS claims expenditure review. The analysis started with an overall health sector expenditure review, zoomed into NHIS claims expenditure in Volta region as a miniature for the scheme, and followed by identifictation of factors affecting level and efficiency of expenditure. This study is the first attempt to undertake systematic in-depth analysis of NHIS claims expenditure. Based on the study findings, it is recommended that NHIS establish a stronger expenditure control system in place for long-term sustainability. The majority of NHIS claims expenditure is for outpatient consultations, district hospitals and above, certain member groups (e.g., informal group, members with more than five visits in a year). These distribution patterns are closely related to NHIS design features that encourages expenditure surge. For example, year-round open registration boosted adverse selection during enrollment, essentially fee-for-service provider mechanisms incentivized oversupply but not better quality and cost-effectiveness, and zero patient cost-sharing by patients reduced prudence in seeking care and caused overuse. Moreover, NHIA is not equipped to control expenditure or monitor effect of cost-containment policies. The claims processing system is mostly manual and does not collect information on service delivery and results. No mechanisms exist to monitor and correct providers’ abonormal behaviors, as well as engage NHIS members for and engaging members for information verification, case management and prevention.
Download or read book Private Health Insurance written by Sarah Thomson and published by Cambridge University Press. This book was released on 2020-10-01 with total page 593 pages. Available in PDF, EPUB and Kindle. Book excerpt: Can private health insurance fill gaps in publicly financed coverage? Does it enhance access to health care or improve efficiency in health service delivery? Will it provide fiscal relief for governments struggling to raise public revenue for health? This book examines the successes, failures and challenges of private health insurance globally through country case studies written by leading national experts. Each case study considers the role of history and politics in shaping private health insurance and determining its impact on health system performance. Despite great diversity in the size and functioning of markets for private health insurance, the book identifies clear patterns across countries, drawing out valuable lessons for policymakers while showing how history and politics have proved a persistent barrier to effective public policy. This title is also available as Open Access on Cambridge Core.
Download or read book Scaling Up Affordable Health Insurance written by Alexander S. Preker and published by World Bank Publications. This book was released on 2013-05-31 with total page 894 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents an in-depth review on the role of health care financing in improving access for low-income populations to needed care, protecting them from the impoverishing effects of illness, and addressing the important issues of social exclusion in government financed programs.
Download or read book Health Insurance Handbook written by Hong Wang and published by World Bank Publications. This book was released on 2012-01-18 with total page 141 pages. Available in PDF, EPUB and Kindle. Book excerpt: Many countries that subscribe to the Millennium Development Goals (MDGs) have committed to ensuring access to basic health services for their citizens. Health insurance has been considered and promoted as the major financing mechanism to improve access to health services, as well to provide financial risk protection.
Download or read book Health Care Financing and Insurance written by Francesco Paolucci and published by Springer Science & Business Media. This book was released on 2010-10-28 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: As a contribution to the search for suitable and sustainable solutions to finance rising medical care expenditures, the book proposes a typology of healthcare financing and insurance schemes, based on the dimensions of basic vs. supplementary services and mandatory vs. voluntary coverage, to analyse the design and the complex interactions between various financing and insurance arrangements in several OECD countries. This study provides a better understanding of the strengths and weaknesses of the financial and organisational structures of different countries’ healthcare financing and insurance schemes. Its main contributions are the development of a novel and rigorous theoretical framework analysing the economic rationales for the optimal design of healthcare financing and insurance schemes, and an empirical and institutional analysis investigating the consequences for efficiency and affordability of the complex interactions between basic and supplementary sources of financing.
Download or read book Financing Health Services Through User Fees and Insurance written by R. Paul Shaw and published by Washington, D.C. : World Bank, c1995 (1996 printing). This book was released on 1995 with total page 268 pages. Available in PDF, EPUB and Kindle. Book excerpt: World Bank Discussion Paper No. 294. Presents case studies that focus on user fees and self-financing health insurance as a means of contributing to efficiency, equity, and sustainable financing in the health sector. User fees are emphasized as a form of cost-sharing because private, out-of-pocket expenditures for health account for nearly one-half of total expenditures in Africa. Evidence presented in this report suggests that self-financing insurance is more prevalent in many countries than had been previously thought.
Download or read book Social Health Insurance for Developing Nations written by R. Paul Shaw and published by World Bank Publications. This book was released on 2007-01-01 with total page 188 pages. Available in PDF, EPUB and Kindle. Book excerpt: Specialist groups have often advised health ministers and other decision makers in developing countries on the use of social health insurance (SHI) as a way of mobilizing revenue for health, reforming health sector performance, and providing universal coverage. This book reviews the specific design and implementation challenges facing SHI in low- and middle-income countries and presents case studies on Ghana, Kenya, Philippines, Colombia, and Thailand.
Download or read book Health Systems Financing written by World Health Organization and published by World Health Organization. This book was released on 2010 with total page 132 pages. Available in PDF, EPUB and Kindle. Book excerpt: "This World Health Report was produced under the overall direction of Carissa Etienne ... and Anarfi Asamoa Baah ... The principal writers were David B. Evans ... [et al] -- t.p. verso.
Download or read book Impact of Health Insurance in Low and Middle income Countries written by Maria-Luisa Escobar and published by Brookings Institution Press. This book was released on 2010 with total page 239 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance-based care is key to the public policy debate of whether to extend insurance to low-income populationsand if so, how to do itor to serve them through other means.
Download or read book Health Financing and Spending in Low and Middle Income Countries written by Mihajlo (Michael) Jakovljevic and published by Frontiers Media SA. This book was released on 2022-02-09 with total page 101 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Financing Health Services in Developing Countries written by John S. Akin and published by World Bank Publications. This book was released on 1987-01-01 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: This report discusses several different approaches that support reforming health care services in developing countries. For some time now, health care services have been supported by government funds. As demands for improving health care services continue to increase additional demands will be placed on governments to respond. This, however, will not be easy. Slow economic growth and record budget deficits in the 1980's have forced reductions in public spending. Alternative approaches to finance health care services are needed. Such possible changes could involve: decentralization of federal government involvement; the promotion of nongovernment involvement; the imposition of user fees; and, establishing health insurance. Finally, the role of the Bank in pursuing new financing strategies is discussed.
Download or read book Crossing the Global Quality Chasm written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2019-01-27 with total page 399 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Download or read book Making Health Financing Work for Poor People in Tanzania written by Dominic Haazen and published by World Bank Publications. This book was released on 2012-02-13 with total page 117 pages. Available in PDF, EPUB and Kindle. Book excerpt: Tanzania is currently developing a Health Financing Strategy to provide a medium to long-term road map for a sustainable and integrated health financing system. This book is designed to inform this discussion by providing an analytical basis for the discussion of options, a series of policy options which could be considered in moving forward, and the economic and financial implications of these options. In doing so, it is hoped that this book will help stimulate the discussion of options and help Tanzania develop a health financing strategy which meets its long-term needs. Health financing in Tanzania is currently highly fragmented, with many different sources of funds and programs directed at specific population groups. Despite this, many people still do not access health services because of financial barriers, and this burden falls disproportionately on the poor. This book looks at the current situation with respect to health financing as well as the experience in other countries to address health financing for the poor and the population generally, using a common analytical framework. The book then explores a number of options in the areas of revenue generation, pooling of funds, purchasing and service provision, and also looks at the regulatory and political environment, making specific recommendations which can be considered in each of these areas. The focus of these recommendations is particularly on improving financial health protection for the poor. The economic, financial and service delivery implications are then examined, using several different scenarios for extending pre-paid health insurance coverage to the population. Making Health Financing Work for the Poor in Tanzania will be of interest to readers working in the areas of health care and public health, social protection, and social analysis and policy, in Tanzania and in other countries aiming for improvements in their health financing systems.
Download or read book Improving Health Care in Low and Middle Income Countries written by Lani Rice Marquez and published by Springer Nature. This book was released on 2020-05-26 with total page 254 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book is a collection of 12 case studies capturing decades of experience improving health care and outcomes in low- and middle-income countries. Each case study is written by healthcare managers and providers who have implemented health improvement projects using quality improvement methodology, with analysis from global health experts on the practical application of improvement methods. The book shows how frontline providers in health and social services can identify gaps in care, propose changes to address those gaps, and test the effectiveness of their changes in order to improve health processes and outcomes. The chapters feature cases that provide real-life examples of the challenges, solutions, and benefits of improving healthcare quality and clearly demonstrate for readers what quality improvement looks like in practice:Addressing Behavior Change in Maternal, Neonatal, and Child Health with Quality Improvement and Collaborative Learning Methods in GuatemalaHaiti’s National HIV Quality Management Program and the Implementation of an Electronic Medical Record to Drive Improvement in Patient CareScaling Up a Quality Improvement Initiative: Lessons from Chamba District, IndiaPromoting Rational Use of Antibiotics in the Kyrgyz RepublicStrengthening Services for Most Vulnerable Children through Quality Improvement Approaches in a Community Setting: The Case of Bagamoyo District, TanzaniaImproving HIV Counselling and Testing in Tuberculosis Service Delivery in Ukraine: Profile of a Pilot Quality Improvement Team and Its Scale‐Up JourneyImproving Health Care in Low- and Middle-Income Countries: A Case Book will find an engaged audience among healthcare providers and administrators implementing and managing improvement projects at Ministries of Health in low- to middle-income countries. The book also aims to be a useful reference for government donor agencies, their implementing partners, and other high-level decision makers, and can be used as a course text in schools of public health, public policy, medicine, and development. ACKNOWLEDGMENT:This work was conducted under the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project, USAID Award No. AID-OAA-A-12-00101, which is made possible by the generous support of the American people through the U.S. Agency for International Development (USAID). DISCLAIMER:The contents of this book are the sole responsibility of the Editor(s) and do not necessarily reflect the views of USAID or the United States Government. div=""^
Download or read book Health Financing in Ghana written by George Schieber and published by World Bank Publications. This book was released on 2012-08-30 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume analyzes Ghana s National Health Insurance Scheme and highlights the range of policy options needed to assure its financially sustainable transition to universal coverage.
Download or read book Health Financing in Ghana written by George Schieber and published by World Bank Publications. This book was released on 2012-08-14 with total page 197 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ghana is one of only several African countries to enact legislation and earmark financing for universal health insurance coverage for its entire population. Seven years into its implementation the Ghana National Health Insurance Scheme (NHIS) has made significant progress in transitioning to universal coverage, but faces significant fiscal and coverage challenges. This study reviews Ghana's health financing system with a special emphasis on its National Health Insurance Scheme. Such an assessment is important because Ghana is often considered a global 'good practice' in terms of earmarking significant amounts of its general revenues for health insurance coverage, providing formal coverage to its vulnerable population groups, and extending coverage by transitioning its existing community health insurance schemes into a national health insurance program. In addition to the global interest in the Ghana 'model', this review is timely in view of recent critiques of the system and questions about its financial sustainability. The study is also unique in terms of evaluating Ghana's NHIS in terms of basic health system goals of health outcomes, financial protection, consumer satisfaction, equity, efficiency, and financial sustainability. The strengths and weaknesses of Ghana's health financing system are assessed on the basis of these performance goals to provide the current health policy reform baseline. The assessment is also based on several new and updated sources of information on: total health spending, inputs, outcomes, household spending, and the macro economy. It also undertakes for the first time an extensive international benchmarking analysis; assesses the financial protection/equity of the system at both macro and micro levels; and, contains an extensive fiscal space analysis based on Ghana's new macroeconomic realities (i.e., the revaluation of Ghana's Gross Domestic Product (GDP) upward by some 60 percent in November 2010, making Ghana a lower middle income country). The study concludes with an assessment of potential structural and operational reform options to assure NHISs long-term efficacy and sustainability in the context of its future available fiscal space.
