东南亚卫生融资改革:实现全民覆盖的挑战
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
概括
东南亚的医疗融资改革旨在减少自付费用,扩大医疗覆盖范围. 挑战包括资助和识别穷人,但社会医疗保险和税收资助的计划显示出普遍医疗覆盖的希望.
科学领域:
- 卫生政策和融资 卫生政策和融资
- 全民健康覆盖 全民健康覆盖
- 东南亚的医疗保健系统
背景情况:
- 东南亚国家正在实施医疗融资改革,以减少对自付支付的依赖.
- 关键目标包括增加公共卫生融资和扩大服务利用率,以实现全民覆盖.
- 像老和柬埔寨这样的资源贫困国家面临着通过卫生公平基金资助和准穷人的挑战.
研究的目的:
- 审查七个东南亚国家的卫生融资改革.
- 分析减少自付费用和实现全民健康覆盖的战略.
- 评估不同融资机制的有效性及其对金融保护的影响.
主要方法:
- 七个东南亚国家的卫生融资改革的比较分析.
- 审查社会医疗保险,健康股权基金,缴费安排和税收资助计划.
- 检查扩大覆盖范围和金融保护的挑战和促进因素.
主要成果:
- 在泰国,菲律宾,印度尼西亚和越南,社会医疗保险对于正式部门的员工来说是常见的,其财务保护结果各不相同.
- 在老和柬埔寨,由捐助者支持的健康股权基金被利用,这些国家在可持续融资和准确准方面面临挑战.
- 贡献性安排和税收资助计划为非贫困人口提供了替代途径,在覆盖范围扩张的速度上有所不同.
- 财政空间和工资缴费动员对于加速金融保护至关重要.
结论:
- 医疗融资改革是复杂的,需要仔细考虑不同的机制,如社会医疗保险和税收融资计划.
- 解决融资,定位和提供者支付方面的挑战对于成功的改革至关重要.
- 加强机构的证据生成和政策信息的能力,对于实现全民健康覆盖来说至关重要.
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