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Financiamiento de la salud para promover el acceso en entornos de bajos ingresos: ¿cuánto sabemos?
Natasha Palmer1, Dirk H Mueller, Lucy Gilson
1London School of Hygiene and Tropical Medicine, London, UK. natasha.palmer@lshtm.ac.uk
Lancet (London, England)
|October 12, 2004
Resumen
Las tarifas de los usuarios dificultan el acceso a los servicios de salud en las naciones de bajos ingresos. Si bien el pago anticipado y las transferencias condicionales de efectivo muestran potencial, el contexto es importante y una mejor financiación de la investigación es crucial para la financiación de la salud basada en la evidencia.
Área de la Ciencia:
- Economía de la salud Economía de la salud
- Política de salud pública Política de salud pública.
- Desarrollo internacional Desarrollo internacional.
Sus antecedentes:
- Las estrategias de financiación de la salud impactan significativamente el acceso a la atención médica y los resultados en los países de bajos ingresos.
- La investigación desde 1995 ha explorado varios modelos de financiación, incluidas las tarifas de usuario, los esquemas de pago anticipado y las transferencias condicionales de efectivo.
Objetivo del estudio:
- Revisar y sintetizar la investigación sobre los efectos de las diferentes estrategias de financiación de la salud en la utilización y los resultados de los servicios de salud.
- Para identificar lagunas y limitaciones en la base de evidencia actual.
Principales métodos:
- Revisión sistemática y síntesis de los estudios publicados desde 1995 en adelante.
- Análisis de la investigación centrada en los contextos de los países de bajos ingresos.
Principales resultados:
- Las tarifas de los usuarios generalmente disuaden la utilización de los servicios de salud.
- Los planes de pago anticipado y de seguros muestran potencial para mejorar el acceso, pero son limitados en su alcance.
- Las transferencias de efectivo condicionales pueden aumentar la absorción de la intervención, pero pueden crear incentivos no deseados.
Conclusiones:
- La efectividad de las estrategias de financiación de la salud es altamente dependiente del contexto, como lo demuestran las variaciones regionales en los hallazgos.
- Existe una necesidad crítica de investigación de mayor calidad y un mayor financiamiento inicial para evaluar las iniciativas de financiación de la salud para informar la política y lograr los objetivos de desarrollo.
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