東南アジアにおける医療財政改革:普遍的な医療普及を達成する上で直面する課題
Viroj Tangcharoensathien1, Walaiporn Patcharanarumol, Por Ir
1International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand. viroj@ihpp.thaigov.net
Lancet (London, England)
|January 29, 2011
まとめ
東南アジアにおける医療財政改革は,自費支給を削減し,医療保険の範囲を拡大することを目的としています. 課題には,貧困層の資金調達と特定が含まれていますが,社会医療保険と税金で賄われる制度は,普遍的な健康保険の実現を約束しています.
科学分野:
- 健康政策と資金調達について
- 普遍的な健康保険制度を導入する
- 東南アジア保健医療システム
背景:
- 東南アジア諸国は,自費支給への依存を減らすために,医療資金改革を実施しています.
- 主要な目標は,医療費の統合を拡大し,普遍的な医療保障を目指してサービスの利用率を拡大することです.
- ラオスやカンボジアのような資源が乏しい国々は,ヘルス・エクイティ・ファンドを通じて貧困層への資金提供とターゲット付けで課題に直面しています.
研究 の 目的:
- 7つの東南アジア諸国における保健財政改革の見直し.
- ポケットからの支払いを削減し,普遍的な健康保険の実現のための戦略を分析する.
- 異なる資金調達メカニズムの有効性とその金融保護への影響を評価する.
主な方法:
- 7つの東南アジア諸国における保健財政改革の比較分析.
- 社会医療保険,健康資本基金,有給制度,税金で賄われる制度の見直し
- カバレッジの拡大と金融保護の課題と促進要因の検討.
主要な成果:
- 泰国,フィリピン,インドネシア,ベトナムの正規部門の従業員には社会医療保険が一般的であり,経済的保護の成果は様々である.
- 寄付者によって支援される健康資本金は,ラオスとカンボジアで活用されており,持続可能な資金調達と正確なターゲティングの課題に直面しています.
- 貢献型制度や税金で賄われる制度は,非貧困層の住民に代替的経路を提供しているが,その範囲の拡大のスピードは異なる.
- 財政的空間と給与手数料の動員は,金融保護の加速に不可欠です.
結論:
- 医療財政改革は複雑で,社会医療保険や税金で賄われる制度など,さまざまなメカニズムを慎重に検討する必要がある.
- 資金調達,ターゲティング,プロバイダの支払いに関する課題に対処することは,改革の成功にとって不可欠です.
- 証拠の生成と政策の情報提供のための制度的能力を強化することは,普遍的な健康保険の実現に不可欠です.
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