低所得者層へのアクセスを促進するための医療資金調達 - 私たちはどのくらい知っていますか?
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
まとめ
ユーザー料金は,低所得国における医療サービスへのアクセスを妨げています. 預金や有条件の現金移転が潜在的であることを示す一方で,根拠に基づいた医療資金調達には,文脈が重要であり,よりよい研究資金が不可欠である.
科学分野:
- 健康経済学 医療経済学
- 公共衛生政策 公共衛生政策
- 国際開発国際開発
背景:
- 医療資金調達戦略は,低所得国における医療へのアクセスと医療成果に大きな影響を与えます.
- 1995年以来の研究は,ユーザー手数料,前払い制度,条件付きの現金送金など,さまざまな資金調達モデルを探索してきました.
研究 の 目的:
- 医療サービスの利用と成果に対するさまざまな医療資金調達戦略の影響に関する研究をレビューし,統合する.
- 現在のエビデンスベースにおけるギャップや限界を特定する.
主な方法:
- 1995年以降に発表された研究の体系的レビューと要約.
- 低所得国の状況に焦点を当てた研究の分析.
主要な成果:
- ユーザー料金は,一般的に,医療サービスの利用を妨げています.
- 預金や保険制度は,アクセスの改善の可能性を示しているが,範囲は限られている.
- 条件付きの現金移転は,介入の利用を増加させるが,意図しないインセンティブを生み出す可能性がある.
結論:
- 医療の資金調達戦略の有効性は,地域的な差異によって示されるように,非常に文脈に依存しています.
- 政策を策定し,開発目標を達成するために,より質の高い研究と,医療資金調達イニシアチブを評価するための初期資金の増加が不可欠です.
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