实证证据和概念框架来解决印度卫生服务资金不足的挑战
Junying Zhao1, Rashmi Jaggad2, James R Kennedye3
1Department of Health Administration and Policy, University of Oklahoma Health Sciences, Oklahoma City, Oklahoma, USA.
概括
由于各个阶段的预算削减,印度卫生服务 (IHS) 长期缺乏资金. 垂直公平,而不是效率,证明了增加拨款的合理性,但强制性支出的立法提案失败了.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 卫生经济学 卫生经济学
- 公共政策 公共政策
背景情况:
- 印度卫生服务局 (IHS) 为美洲印第安人和阿拉斯加原住民 (AIAN) 提供关键医疗保健.
- IHS有一个持续且严重的资金不足问题,影响了服务提供.
- 了解财政管理和经济因素对于解决IHS资金不足至关重要.
研究的目的:
- 检查印度卫生服务 (IHS) 资金不足的程度,原因和潜在解决方案.
- 在IHS预算流程的不同阶段分析预算差异.
- 评估建议的基准和解决方案,使用经济标准,如效率和公平.
主要方法:
- 从财政管理的角度使用了15年的定量和定性数据.
- 从经济角度开发了一个概念框架来分析IHS融资.
- 应用效率和公平标准来评估预算提案和解决方案.
主要成果:
- 确定了预算规划和批准的具体阶段,其中发生了显著的IHS预算削减.
- 美国联邦信托对AIAN医疗保健的责任被视为自由裁量权,而不是强制性支出.
- 垂直公平,而不是分配效率,为增加IHS拨款提供了更强有力的理由.
- 在2001年至2004年期间,立法机构试图为IHS建立权利强制性支出,但没有成功.
- 总统关于2024财年的关于无权强制性支出和扣押豁免的提案没有得到批准.
结论:
- 这项研究是首次评估IHS预算提案在整个颁布过程中的差异.
- 阐明了资金不足发生的具体阶段,为未来的研究和政策提供了信息.
- 为IHS,部落国家和美国国会提供有关预算政策制定的关键见解.
相关概念视频
01:18Introduction To Health Care Delivery System
3.7K
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
3.7K
01:26Methods Of Healthcare Delivery System
3.9K
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
3.9K
01:29Issues And Trends In Healthcare Delivery System
6.1K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
6.1K
01:30Community Based Intervention
265
Community-based interventions in mental health represent a paradigm shift from institution-centered care to treatments embedded within the fabric of local communities. By prioritizing inclusion and leveraging existing societal structures, this approach fosters a supportive environment conducive to addressing mental health challenges while promoting individual dignity and agency.
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
265
01:15Methods of Documentation VI: Case Management Model
847
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic...
For example, a patient with a chronic...
847
01:30Health Information Technology and Healthcare Information System
3.3K
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
3.3K