疾病対策の優先事項の重要なメッセージ 第3版
Dean T Jamison1, Ala Alwan2, Charles N Mock2
1University of California, San Francisco, San Francisco, CA, USA.
Lancet (London, England)
|November 29, 2017
まとめ
疾病管理の優先事項 第3版 (DCP3) は,低中所得国における年間420万人の早期死亡を削減することを目指した,普遍的な健康保険の21の基本的健康パッケージを概説しています. この目標を達成するには,かなりの投資と多部門間の行動が必要です.
科学分野:
- 世界保健
- 健康 経済
- 公衆衛生政策
背景:
- 世界銀行の疾病管理優先事項第3版 (DCP3) は,2015年から2018年の間に出版された9巻で構成されています.
- 第9巻は,DCP3の全巻の主要なメッセージと横断的な分析を統合し,健康改善と貧困削減に焦点を当てています.
研究 の 目的:
- DCP3の全9巻から得られた結論を伝え,普遍的な健康保険の実現における基本的な健康パッケージの役割を強調する.
- 各国の優先順位設定の出発点として218の介入を備えた基本的普遍的健康保険 (EUHC) のモデル概念を提示する.
主な方法:
- 分析は,各分野間の政策と保健部門の介入を組み合わせた21の重要なパッケージを中心に構築されました.
- 71の分野間の予防政策を特定し,そのうち29の政策は早期導入を優先する.
- 保健部門の介入を5つのプラットフォームに分類する. 人口ベース,コミュニティレベル,保健センター,第一レベルの病院,紹介病院.
主要な成果:
- EUHCを2030年までに実施すれば,低中所得国では毎年推定420万人の早期死亡を減らすことができる.
- EUHCの推定総コストは高額で,低所得国のGNIの9.1%,中低所得国のGNIの5.2%を占めています.
- 低中所得国におけるEUHCによる死亡率の減少は,非伝染病に関する持続可能な開発目標の半分しか達成できない.
結論:
- 死亡率削減の目標を達成するには 投資を増やし 持続的な分野間行動と 有害な製品への課税や 化石燃料への補助金の削減などの 財政政策が必要です
- DCP3は,国家レベルの分析のためのモデルを提供し,国家特有の文脈が,EUHCに合わせた定義を必要とすることを認めています.
- EUHCの達成はますます国内資金に依存し,世界的な援助はグローバルな公共財に重点を置いています.
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