結果を買うのか? 開発途上国における医療サービスの提供に関する契約
Benjamin Loevinsohn1, April Harding
1World Bank, 1818 H Street NW, Mailstop MC11-1106, Washington DC, USA. bloevinsohn@worldbank.org
Lancet (London, England)
|August 23, 2005
まとめ
非政府機関 (NGO) との契約は,初等保健医療の提供を大幅に改善し,さまざまな環境で迅速かつ持続的な結果を示しています. この費用対効果の高い戦略は,年間一人当たり3~6ドルで,グローバルに拡大すべきです.
科学分野:
- 公衆衛生は公衆衛生である.
- 医療サービス管理 医療サービス管理
- 国際保健 国際保健
背景:
- 保健サービス提供の改善は,世界保健目標の達成に不可欠です.
- 非政府機関 (NGO) などの非国家団体との契約は,医療の強化のための提案された戦略です.
- 医療サービスの契約に関する世界的な経験は,包括的なレビューを必要とします.
研究 の 目的:
- 医療サービス提供の契約に関する世界的な経験をレビューする.
- プライマリケア契約の有効性と持続可能性を評価する.
- 契約された基本的な保健サービスの費用対効果を決定する.
主な方法:
- プライマリーケア提供の契約に関する10の世界的なケーススタディのレビュー.
- 契約サービスの有効性,持続可能性,およびコストの分析.
- 様々な医療環境における課題と成功の評価.
主要な成果:
- プライマリケア提供の契約は,多くの環境において,著しい効果と急速な改善を示した.
- 予想された契約上の困難は最小限か,または有効性を妨げなかった.
- 9つの長期契約 (3年以上の契約) のうち7つが継続・拡張された.
- 基本的なサービスパッケージのコストは,低所得国において,年間一人当たり約3~6米ドルであった.
結論:
- 非国家機関,特にNGOとの契約は,初等医療の改善のための非常に効果的な戦略です.
- このモデルは,低所得環境において持続可能で,スケーラブルで,費用対効果が高い.
- 医療サービス契約の拡大が推奨され,将来の取り組みの厳格な評価が伴います.
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