To see the other types of publications on this topic, follow the link: Health care expenditures financing.
Journal articles on the topic 'Health care expenditures financing'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Health care expenditures financing.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Rasell, Edith, Jared Bernstein, and Kainan Tang. "The Impact of Health Care Financing on Family Budgets." International Journal of Health Services 24, no. 4 (October 1994): 691–714. http://dx.doi.org/10.2190/mm38-p4hv-2w32-4kyr.
Full textAbstract:
Although businesses, federal and state governments, and insurance companies are major funding sources for health care, they are just intermediate sources. Ultimately, individuals and families pay all health care costs through out-of-pocket spending, insurance premiums, or federal, state, and local taxes. Using a microsimulation model with data from the 1987 National Medical Expenditure Survey, the Internal Revenue Service's Individual Tax Model, and the Consumer Expenditure Survey, the authors examine the distribution of health care spending, by decile, among families and individuals. They find that the distribution of health expenditures is very regressive, with low-income families paying twice the share of income paid by high-income families. The distribution of out-of-pocket expenditures, which comprise 24 percent of total spending, is the most regressive, with low-income families paying 8.5 times the share of income paid by high-income families. Spending on premiums is also regressive, and the regressivity would increase if everyone had private insurance. Expenditures through the public sector are progressive. Regressivity is greater among the elderly than the nonelderly. Out-of-pocket expenditures account for 41 percent of all health care spending by the elderly. A more equitably financed health care system would increase the share of funding raised through progressive taxes, and decrease reliance on expenditures made out of pocket and on premiums.
2
Siegel, Bruce, Holly Mead, and Robert Burke. "Private Gain and Public Pain: Financing American Health Care." Journal of Law, Medicine & Ethics 36, no. 4 (2008): 644–51. http://dx.doi.org/10.1111/j.1748-720x.2008.00318.x.
Full textAbstract:
Virtually all Americans are part of the health care system. They may be patients, health professionals, employers providing benefits, insurers, medical manufacturers, regulators, innovators, or investors. Each has a stake in this burgeoning sector of the United States economy, and each may be critically affected, in multiple and diverse ways, by changes to the system under health reform. As health care expenditures continue to rise, it is increasingly important to understand where these expenditures go and the factors that drive these cost increases. This article examines health care expenditure patterns, considering both the “usual suspects” that frequently are cited as spending drivers, as well as certain significant dynamics that may be the main contributors to rising costs. We conclude that in order to successfully contain costs, health reform will need to address these underlying factors.
3
Senturk, Bilge, Aysun Danisman Isik, and Cisel Ekiz Gokmen. "Determinants of out of pocket healthcare expenditures: The case of Mugla province in Turkey." Global Journal of Business, Economics and Management: Current Issues 9, no. 2 (July 31, 2019): 76–83. http://dx.doi.org/10.18844/gjbem.v9i2.4225.
Full textAbstract:
As the share of health care financing from public funds was increasing in Turkey, the utilization of the health care services has also increased, dramatically. Despite of universal health coverage, the result of this trend causes to increase the incidence of making out of pocket expenditures. The aim of this study is to evaluate the determinants of households’ health expenditures in Mugla province of Turkey. A total of 204 households living in the central district of Mugla were surveyed and questioned both for their total consumption and health expenditures, as well as their health status, demographic and socio-economic characteristics. Ordinary least square method was used for the multiple regression analysis to identify the factors that affect the out of pocket health care expenditures. In addition to other empirical studies in Turkey, the effects of relative poverty and types of income and occupation on oop expenditures were estimated. Results identify that consumption expenditure of the household, poverty, wage/income status, education, household size, having chronic disease and having elderly in the households have significant effects on the amount of out of pocket (oop) health expenditure of the households.
Keywords: Health care financing; Out of pocket payments; Ordinary least square method; Turkey
4
Potapchik, E. G. "WHICH HEALTH FINANCING MODEL IS BETTER: TAX-FINANCED OR SOCIAL HEALTH INSURANCE? WHAT DOES INTERNATIONAL EXPERIENCE PROVE?" Social Aspects of Population Health 67, no. 1 (2021): 9. http://dx.doi.org/10.21045/2071-5021-2021-67-1-9.
Full textAbstract:
In Russia disputes on the need to abandon Compulsory Health Insurance (CHI) and return to the tax-based financing are yet to subside. At present, after the statement of the President of the Russian Federation V. Putin about the possibility to establish a state health care corporation, discussions on the issue have only escalated. Purpose. To conduct a comparative assessment of the public health financing model impact on the access and structural characteristics of health care delivery in the developed countries. Material and methods. Assessment of the potential impact of public funding models on the health system performance is carried out by analyzing variations in the main indicators of financial access, health care uptake and health status of the population, achieved in the developed countries with different health financing models. Results. Health care expenditures in countries with CHI are higher than in countries with the tax-based financing model. In countries with CHI the share of administrative expenses is slightly higher than in countries with the tax-based financing system. The share of spending on preventive care is slightly higher in countries with the tax-based financing system. There is a slightly lower level of outpatient and inpatient care uptake in countries with the tax-based financing system compared to countries with CHI. The premature mortality rate in countries with CHI is slightly lower than in countries with the tax-based system. Conclusion. The obtained data indicate that there are no significant differences in the access and structural characteristics of medical care in the health care system of the developed countries with different financing models. The main difference remains the level of health expenditures. In countries with CHI, the level of health expenditures is higher than in countries with the tax-based financing, which is largely due to the existence of a separate source of funding. The level of administrative costs in countries with CHI is also higher than in countries with the tax-based system.
5
Lisovska, Olha. "SYSTEM OF FINANCING HEALTH CARE IN THE EUROPEAN UNION COUNTRIES AS AN EXPERIENCE FOR UKRAINE." Three Seas Economic Journal 2, no. 1 (April 26, 2021): 48–52. http://dx.doi.org/10.30525/2661-5150/2021-1-8.
Full textAbstract:
Purpose. The purpose of the article is to analyse the state of the system of financing health care in the European Union countries and Ukraine, to identify and compare their efficiency. To achieve this purpose, the following tasks were set: to analyse the current state of the system of financing health care in the European Union using up-to-date statistics on health care expenditures; to analyse the state of the system of financing health care in Ukraine for the last five years based on statistical data on expenditures of the Consolidated Budget of Ukraine; to consider what needs the health care sector directs expenditures to; to identify the problems that were prompted medical reform in Ukraine; to identify and compare the efficiency of financing the health care system of the European Union countries and Ukraine. Methodology. During the preparation of the article, the author used the method of analysis and synthesis to review statistical data that provided an opportunity to analyse the current state of the system of financing health care in the European Union countries and Ukraine; the method of comparison was used to determine the efficiency of the models of the system of financing health care in the countries of the European Union, in order to further form useful advice for use in Ukraine during the period of medical reform; generalization method was used to summarize the results of the study. Results. Analysing the state of the system of financing health care among the European Union countries in 2019, it was found that the largest amount of health care expenditures was in Germany (the system of financing was based on the Bismarck model), and the smallest was in Latvia (the system of financing was based on the Beveridge model). Analysis of the dynamics of health care expenditures in Ukraine showed that over the past five years, the volume of expenditures has increased 2.33 times. In terms of the funds of the Consolidated Budget of Ukraine, the largest percentage (85-91%) falls on the expenditures of the general fund. In relation to the total expenditures of the Consolidated Budget of Ukraine, the share of health care expenditures in 2020 has amounted to 11.02%, which is 1.99% higher than in 2016. Despite the growing trend, the amount of budget expenditures is not enough for all the needs of the health sector. To identify the efficiency of the models of the systems of financing health care operating in the European Union countries and Ukraine, a comparison of the average life expectancy among the people of these countries was made. In the countries of Northern and Western Europe, there was the highest rate in the range of 81.1-83.1 years for both men and women; the lowest rate was observed in Ukraine (73 years). Ukraine is currently undergoing health care reform, which should change the Soviet model to one that will be closer to the English, which shows its efficiency on the example of European countries in the post-Soviet space. Practical implications. The results of the study can be used to form practical suggestions in preparation for the next stage of health care reform in Ukraine.
6
Stepanova, Olena. "COVID-19 pandemic and fiscal sustainability." Economy and forecasting 2020, no. 2 (October 12, 2020): 5–15. http://dx.doi.org/10.15407/econforecast2020.02.005.
Full textAbstract:
The article deals with the impact of the COVID-19 pandemic on the financing of the health care system, and the main challenges to the stability of the financial mechanisms of post-pandemic health care development have been identified. The author substantiates the peculiarities of the crisis of health care financing in the conditions of the current pandemic, further economic recession and decreased fiscal sustainability. The global practice of fiscal response to the manifestations of the COVID-19 pandemic has been systematized and the volumes of the corresponding financing in the countries with insurance and budgetary systems of health care financing have been estimated. The article identifies mechanisms for the transformation and expansion of the fiscal space in the context of expanded financing of the growing need for medical care in the face of new epidemic risks in different countries. Most often, the expansion of a country's fiscal space is carried out by: redistributing the existing amount of government expenditure for health care and redirecting funding flows from financing certain types of medical care to financing programs to overcome and combat COVID-19; changes in the priority of government health expenditure to combat COVID-19 compared to other budget expenditures on the social sphere and economic development; and using national reserve funds and emergency funds. It has been found that in the field of health care, the vast majority of countries have reduced the economic and territorial deprivation of all population groups in access to the diagnosis and treatment of COVID-19. The author emphasizes the weaknesses of insurance based and decentralized health financing mechanisms to respond to the growing need for health care and financial stability during the pandemic. Substantiated the necessity to expand the fiscal space needed to cover the fiscal gap in Ukraine caused by the requirement to increase health care financing in response
7
Hotchkiss, D. R., J. J. Rous, K. Karmacharya, and P. Sangraula. "Household Health Expenditures in Nepal: Implications for Health Care Financing Reform." Health Policy and Planning 13, no. 4 (January 1, 1998): 371–83. http://dx.doi.org/10.1093/heapol/13.4.371.
Full text
8
Kremastioti, Vasiliki, Athanasios Anastasiou, Panagiotis Liargovas, Dimitrios Komninos, and Zacharias Dermatis. "Economic Evaluation of Health Programs – Health Expenditures in the European Union." Valahian Journal of Economic Studies 9, no. 1 (April 1, 2018): 109–18. http://dx.doi.org/10.2478/vjes-2018-0012.
Full textAbstract:
Abstract Health Care is a sensitive issue that concerns not only the individual but also society in general. Health economics are a specialization of the economists in the health sector who aim for the proper function of hospital administration. It deals with issues related to the financing and delivery of health services and the role of such services and other personal decisions in contributing to personal health. Many researches refer to the problems that each health unit faces, emphasizing on the resources, programs and health expenditure. Some of these programs, especially the most effective, are mentioned in this research. Their creation was based on the best quality of health services in all OECD countries. With this research, we aim to develop a methodological framework for evaluating the total health expenditure (consists of all expenditures or outlays for medical care, prevention, promotion, rehabilitation, community health activities, health administration and regulation and capital formation with the predominant objective of improving health) in the 23 OECD countries, by creating a panel data regression and analyzing the results, from 2000 to 2014. For this reason, some of the most important variables (macroeconomic and related to the health sector), were used as tools to assess the performance of each country, as far as the resources and the expenditure for the health care are concerned. Every explanatory variable that was used in this sample, but also the combination of a number of these explanatory variables showed a positive correlation with total expenditures as a percentage of GDP in the majority of the equations. Some variables showed a negative correlation with total health expenditures, which doesn’t fit with the economic theory. Financial crisis is the reason for this.
9
Soares, Adilson. "Health system financing paradigm in the state of São Paulo." Revista de Saúde Pública 53 (May 16, 2019): 39. http://dx.doi.org/10.11606/s1518-8787.2019053000796.
Full textAbstract:
OBJECTIVE: To analyze the allocation of financial resources in the Brazilian Unified Health System (SUS) in the state of São Paulo by level of care, health region, source of funds and level of government. METHODS: This is an exploratory study based on 2014 data extracted from the Public Health Budget Database, presented in absolute terms, relative terms and per capita. RESULTS: In 2014, R$52.1 bi were spent on public health, 58.0% having corresponded to the expenditures of the municipalities and 42.0% to those of the state government. Regional per capita spending varied from R$561.75 to R$824.85. As for the per capita spending on primary health care, which represented 37.5% of the municipalities’ total expenditure, the lowest value was found in the city of São Paulo and the highest, in Araçatuba. Campinas had the highest per capita expenditure on medium and high complexity care, while Presidente Prudente had the lowest. The highest regional percentage of the current net revenue spent on health was verified in Registro, and the lowest, in the city of São Paulo. CONCLUSIONS: The paradigm of the health sector’s financing in São Paulo revealed that the expenditure on primary health care, level elected by health policy as strategic because it depends on coordination and integral health care in the attention networks, was not considered a priority in relation to the expenditure with the medium and high complexity, exposing the iniquities in the state’s regions.
10
PARKHETA, Liudmyla. "THE STATE OFFINANCIAL SECURITYOFTHE HEALTHCARE SECTORIN UKRAINE." WORLD OF FINANCE, no. 4(53) (2017): 156–65. http://dx.doi.org/10.35774/sf2017.04.156.
Full textAbstract:
Introduction. Organization ofeffective functioning and development ofhealth care system in the conditions of limited financial resources is the most important task ofthe authorities at all levels. Therefore, the question ofassessing the current state ofhealth and identifying the main problems of financing health care institutions relevant is more than ever. Purpose. The purpose of the article is to analyze the current state of financial securement ofhealth care in Ukraine. To identify the main problems ofthe development ofthe health sector and to develop recommendations for improving existing and finding new sources of financial support forthe health care system. Results. The results of the analysis show that in recent years, despite an annual increase in health care expenditures, their share in the budget structure is reduced by redistribution to finance other activities ofthe state. The financial support ofhealth care at the state level is extremely insufficient. Apart from the problem of financing health expenditures, attention is drawn to the problem of inefficient and inappropriate use of available resources by the network ofhealth care facilities, which in many cases does not correspond to the real needs ofthe population. Conclusion. It is concluded that the problems of financing health care are largely solved by the introduction of insurance medicine, which ensures not only the ability to receive proper medical care by the population of Ukraine, but also provides effective control by insurance organizations to the rational use of financial resources of the health care sector.
11
Lysiak, Liubov, Svitlana Kachula, and Alina Abdin. "The role of Ukrainian local budget expenditures on health in conditions of decentralization." University Economic Bulletin, no. 46 (September 1, 2020): 144–53. http://dx.doi.org/10.31470/2306-546x-2020-46-144-153.
Full textAbstract:
Relevance of the research topic. The implementation of medical reform in Ukraine, which provides radical structural changes in the health care system, the transformation of financing mechanisms for services, and at the same time the implementation of budgetary reform, an integral part of which is budget decentralization, makes the issue of assessing the role of local budget spending on health care. Formulation of the problem. In conditions of limited budgetary funds, growing debt and budgetary decentralization, successful implementation of health care reform is impossible without increasing the role of local budgets in financing the industry of development priority areas. Analysis of recent research and publications. The works of I. Chygynova, V. Makogon, M. Pasichnogo, Ju. Markuts, I. Kogut, Y. Pasichnik, V. Tropina [1-6] and others are devoted to the study of issues related to the problems of the article. The results of their own research of some of the indicated problems are presented in [6-8]. Segregation of unexplored parts of a common problem. In the context of deepening budget decentralization, strengthening the financial base of local budgets, expanding the functional powers of local governments, it is necessary to further search for ways to increase the role of local budgets in health care financing. The purpose of the article is to assess the role of expenditures of local budgets of Ukraine on the health care sector in the context of deepening budget decentralization and to develop proposals for improving its financing. Duringresearch, general scientific and special methods were used: analysis and synthesis, the method of generalization, statistical, etc. The article analyzes and evaluates the total expenditures of local budgets for health care, as well as for the regional program "Health of the population of the Dnipropetrovsk region for 2020-2024". The attention is focused on increasing the role of local budget expenditures in the process of changing the health financing model. The basis for expanding the capacity of local governments to finance health care was the deepening of budgetary decentralization, changes in the distribution of taxes to local budgets, etc. Conclusions. In conditions of acute limited financial resources, success in the formation and effective use of funds from local budgets of Ukraine for the development of an appropriate health care system is associated, first of all, with the consistent implementation of the financial and budgetary policy of the state, the coherence of medical and budgetary reforms, priorities, increasing the efficiency of the use of budgetary funds in format of target program budgeting. The results of this study can be applied in the process of forming and implementing social and budgetary policies for the development of the health care system in the country.
12
Siljander, Eero. "Incentives of Health Care Expenditure." Farmeconomia. Health economics and therapeutic pathways 13, no. 4 (December 15, 2012): 175–89. http://dx.doi.org/10.7175/fe.v13i4.273.
Full textAbstract:
The incentives of health care expenditure (HCE) have been a topic of discussion in the USA (Obama reforms) and in Europe (adjustment to debt crisis). There are competing views of institutional versus GDP (unit income elasticity) and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs) to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage) remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based) percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of adjustment is 6.6 years or 26 quarters for countries to move half way to the eventual equilibrium in HCE/GDP-ratios in response to a shock in demand factors which indicates “hysteresis” in demand.
13
Kimani, Diana N., Mercy G. Mugo, and Urbanus M. Kioko. "Catastrophic Health Expenditures And Impoverishment In Kenya." European Scientific Journal, ESJ 12, no. 15 (May 30, 2016): 434. http://dx.doi.org/10.19044/esj.2016.v12n15p434.
Full textAbstract:
Background: Out-of-pocket health expenditures leave households exposed to the risk of financial catastrophe and poverty whenever they entail significant dissaving or the sale of key household assets. Even relatively small expenditures on health can be financially disastrous for poor households and similarly, large health care expenditures can lead to financial catastrophe and bankruptcy for rich households. Objective: There is increasing evidence that out-of-pocket expenditures act as a financial barrier to accessing health care, and are a source of catastrophic expenditures and impoverishment. This paper estimates the burden of out-of-pocket payments in Kenya; the incidence and intensity of catastrophic health care expenditure and impoverishment in Kenya. Methods: Using Kenya Household Health Expenditures and Utilization Survey data of 2007, the study uses both descriptive and econometric analysis to investigate the incidence and intensity of catastrophic health expenditures and impoverishment as well as the determinants of catastrophic health expenditures. To estimate the incidence and intensity of catastrophic expenditures and impoverishment, the study used both Wagstaff and van Doorslaer, (2002) and Xu et al. (2005) and applied various thresholds to demonstrate the sensitivity of catastrophic measures. For determinants of catastrophic health expenditures, a logit model was employed. Findings: Among those who utilized health care, 11.7 percent experienced catastrophic expenditures and 4 percent were impoverished by health care payments. In addition, approximately 2.5 million individuals were pushed into poverty as a result of paying for health care. The poor experienced the highest incidence of catastrophic expenditures. Conclusion: The paper recommends that the government should establish avenues for reducing the burden of out-of-pocket expenditures borne by households. This could be through a legal requirement for everyone to belong to a health insurance and targeting the poor, the elderly and chronically ill through the devolved system of the government and devolved funds.
14
Paul, Abhishek, Suresh Chandra Malick, Shatanik Mondal, and Saibendu Kumar Lahiri. "Exploring the determinants of catastrophic health expenditure and socioeconomic horizontal equity in relation to it: a rural community based longitudinal study in West Bengal." International Journal Of Community Medicine And Public Health 5, no. 6 (May 22, 2018): 2522. http://dx.doi.org/10.18203/2394-6040.ijcmph20182189.
Full textAbstract:
Background:Equity in health care is defined as equal access to available care for equal need. Out-of-pocket expenditures are the most inequitable means of health care financing. These payments become catastrophic health expenditure (CHE) if it exceeds the household’s ‘Capacity to Pay’. As fairness is one of the fundamental objectives of the health system, identification of the factors responsible for these expenditures is important. Hence this study was conducted to find out the determinants of CHE and to explore the socioeconomic horizontal equity in relation to it. Methods:Total 352 households from 9 villages of Amdanga block, North 24 Parganas, were studied for 12 months. Annual out-of-pocket healthcare expenditure exceeding 40% of annual household non-food expenditure was classified as CHE and determinants of the same were identified using logit-model. Equity was measured by Concentration index and modified Kakwani measure (MDK). Results:Overall prevalence of CHE was 20.7% and highest (39.3%) in the second income quintile. The odds of incurring CHE were highest (35.43) for the households with member/s requiring inpatient treatment followed by households having more than five members (12.81). Negative value of concentration index and MDK indicated that the probability of incurring CHE was disproportionately concentrated among the poor and the financing system was degressive, however some amount of equity was noted in the poorest quintile. Conclusions:Apart from the poorest section in the community the poorer and middle income sections are still exposed to healthcare expenditure shocks and the health care spending was diverse and less equitable.
15
Yusiuk, M. Yu, A. M. Yusiuk, and L. A. Yusiuk. "HEALTH SYSTEM REFORM IN UKRAINE AND FOREIGN EXPERIENCE OF FINANCING MODELS." Eastern Ukrainian Medical Journal 8, no. 1 (2020): 100–107. http://dx.doi.org/10.21272/eumj.2020;8(1):100-107.
Full textAbstract:
Inroduction. Due to the fact that the reform of the healthcare system in Ukraine is in transition phase at the moment and, in addition, from April 1, 2020 changes are introduced at the second level of healthcare, it is advisable to describe the current state of medical reform in Ukraine, plans and prospects for further implementation and development, as well as the establishment of the features of various health financing systems and comparing the level of expenditures on the medical industry between countries, experience of which should be taken into account. Materials and Methods. The article uses the reports of the Ministry of Health of Ukraine and the analytical materials of medical experts. In addition, when analyzing various models of financing the health system and their features, quantitative indicators of expenditures of the countries surveyed are used. A comparison is made of the level of expenditures on the health care system between Ukraine and some European countries: Great Britain, the Czech Republic, Poland and Germany. Discussion. The main achievements of the first stage of the health care reform and plans for further changes are described. The strengths and weaknesses of each model of financing the health system are identified. It is proved that the level of government spending on the health care system in Ukraine is the smallest among the other countries examined, but one of the largest in terms of payments out of pocket. In addition, a model has been established for financing the health care system in Ukraine, which most fully meets it in modern conditions.
16
Stepanova, O. V. "Fiscal Space for Health Care: Modern Approaches to Formation and Diagnostics." Statistics of Ukraine 81, no. 2 (October 18, 2018): 62–71. http://dx.doi.org/10.31767/su.2(81)2018.02.08.
Full textAbstract:
In the article an analytical review of theoretical approaches to the definition of the fiscal space is conducted. The peculiarities of the interpretation of the essence of the fiscal space for financing the health care system in the contemporary economic researches are explored. It has been determined that fiscal space for the health care system is in fact one of the conceptual approaches for studying the optimal parameters and proportions of financing of the health care, as well as determining the potential reserves for its increase. Based on the study of foreign experience, it is substantiated that the main factors of fiscal space capacity building for health are: macroeconomic context; the need to ensure the fiscal sustainability in the medium and long-term; peculiarities of models of collection of financial resources, accumulation of financial resources and distribution of financing for the medical services; the priority of public financing of the health care system; the possibility of increasing public financing of health care and the introduction of additional mechanisms for increasing financial resources for health care. It is shown that the state can create fiscal space for financing health care system on the basis of three components: financial resources collection system; systems of accumulation of financial resources; system of distribution of financial resources for the provision of medical services to the population.
The analysis of the structure and volume of public health financing in OECD countries has been conducted. The results of the analysis allow us to notice the existence of various proportions of financing the health care, even in the context of the use of identical dominant financing mechanisms. It is determined that among the studied countries the share of countries with the budget financing mechanism of health care is the largest. It is shown that financing of the health care system in Ukraine is considerably smaller than in the OECD countries. The necessity of diagnostics the potential of fiscal space for the health care in Ukraine is substantiated. The indicators of diagnostics of fiscal space for the health care system are systematized in four projections, in particular: indicators of macroeconomic potential; indicators of fiscal capacity; indicators of the pressure of changes in health care expenditures on the fiscal sustainability of; indicators of demographic and social pressure. The need to diagnostics of the potential for fiscal space for health care should be interconnected with indicators of medium and long-term fiscal sustainability.
17
Rezapour, Aziz, Soraya Nooraee Motlagh, Banafsheh Darvishi Teli, Negar Yousef Zadeh, and Payam Haghighat Fard. "Investigating the factors affecting exposure to catastrophic health expenditures among Lorestan households with cancer patients." Pakistan Journal of Medical and Health Sciences 15, no. 6 (June 30, 2021): 1741–48. http://dx.doi.org/10.53350/pjmhs211561741.
Full textAbstract:
Introduction: The present study aims at investigating the most important factors affecting exposure to catastrophic health expenditures among Lorestan households with cancer patients. Methods: Data were collected from 220 households with cancer patients using a questionnaire of the World Health Organization entitled “Global Health Survey”. The research samples were selected through a convenience random sampling method and the researcher randomly interviewed patients who met the inclusion criteria and were willing to participate in the study. Excel software was used to clean data and Eviews and STSA14 software was used for estimation. Results: Based on the results of the study, 70% of households with cancer patients in the study population were exposed to catastrophic health expenditures. The values of Gini coefficient of income, health expenditure concentration index were estimated at 0.16 and 0.26 respectively. The Kakwani index value was estimated to be about 0.1, which showed a progressive trend in financing health expenditures. There was a significant relationship between the exposure to catastrophic health expenditures and the variables of household income status, age, household size, presence of people over 65 years in the household, employment status of the head of household, and type of treatment and cancer type. Conclusion: Based on the results of the study, the rate of exposure to catastrophic health expenditures services in households with cancer patients is high. Thus, these households need more financial support and health system policymakers should increase their supportive policies for these patients by increasing insurance coverages, defining specific health care packages for people with cancer and thus reducing the expenditures of treating these patients. Keywords: Cancer, Household, Catastrophic Health Expenditures, Out-of-Pocket Payments
18
Deber, Raisa B., Kenneth C. K. Lam, and Leslie L. Roos. "Four Flavours of Health Expenditures: A Discussion of the Potential Implications of the Distribution of Health Expenditures for Financing Health Care." Canadian Public Policy 40, no. 4 (December 2014): 353–63. http://dx.doi.org/10.3138/cpp.2014-018.
Full text
19
Moradhvaj and Nandita Saikia. "Gender disparities in health care expenditures and financing strategies (HCFS) for inpatient care in India." SSM - Population Health 9 (December 2019): 100372. http://dx.doi.org/10.1016/j.ssmph.2019.100372.
Full text
20
Bennett, Kevin J., M. Paige Powell, and Janice C. Probst. "Relative Financial Burden of Health Care Expenditures." Social Work in Public Health 25, no. 1 (December 29, 2009): 6–16. http://dx.doi.org/10.1080/19371910802672007.
Full text
21
Melikh, Olena, Inna Irtyshcheva, and Konstantin Bogatyrev. "ORGANIZATIONAL AND ECONOMIC FUNDAMENTALS OF DEVELOPMENT OF SPORTS TOURISM IN THE SYSTEM OF MANAGEMENT OF SPORTS AND HEALTH ACTIVITIES." Baltic Journal of Economic Studies 5, no. 5 (February 8, 2020): 79. http://dx.doi.org/10.30525/2256-0742/2019-5-5-79-83.
Full textAbstract:
The article highlights the approaches to the development of sports and health activities and sports tourism in various spheres of society. It is proved that the current standard of quality of life in Ukraine is characterized as not satisfactory. Many factors affect the quality of life: lifestyle, genetic and environmental factors. However, one of the main issues remains the underfunding of development. The work investigates the state of financial support for health care, which is closely related to the level of low healthy life expectancy. It is determined that in modern conditions physical culture and sports are a necessary element of life of every Ukrainian. It is justified that grant programs are the main financial source for the development of physical culture and sports. It is proved that the state and non-state policy of development of physical education and sports should be built on creation of the corresponding concept for the next five years, which will include the appropriate strategy and program of development of physical culture and sports. The purpose of the article is a study of the peculiarities of organizing sports and health activities in different spheres of society and mechanisms of financing physical culture and sports in Ukraine. To achieve this goal, the following tasks are solved: to reveal the role and importance of organizing sports and health activities in different spheres of society; to conduct an analysis of the current state of financing of health care, physical education and sports; outline strategic guidelines for improving state and non-governmental policies on financial provision for physical education and sports. Subject and object of study. The subject of the research is theoretical and practical aspects of organization of sports and health activities in different spheres of society. The object of the research is the process of managing sports and health activities in different spheres of society. Research methods. For a comprehensive study of the necessary information the basic methods of information research in management were used. In the study of the current state of financing the health care, physical education and sports the methods of statics and dynamics were used. The dynamic method was used to analyze health care expenditures in percentage terms to GDP and total expenditures, average life expectancy at birth in Ukraine, transition from one equilibrium state to another for the period from 1995 to 2017. The static method involved a comparison of the amount of annual funding from the State Targeted Social Program for the Development of Physical Culture and Sports and the actually allocated funds. An economic model of the dynamics of health care expenditures in percentage terms to GDP and total expenditures, average life expectancy at birth in Ukraine in the form of a graph is constructed.
22
Vu, Lan Thi Hoang, Benjamin Johns, Quyen Thi Tu Bui, Anh Duong Thuy, Diu Nguyen Thi, Hien Nguyen Thi, and Anh Nguyen Cam. "Moving to Social Health Insurance Financing and Payment for HIV/AIDS Treatment in Vietnam." Health Services Insights 14 (January 2021): 117863292098884. http://dx.doi.org/10.1177/1178632920988843.
Full textAbstract:
This study estimates the amount antiretroviral therapy (ART) clients paid out of pocket for preventive and treatment services and the percentage of ART clients incurring catastrophic payments during the period when ART services were transitioning from donor funding to domestic social health insurance (SHI) in Vietnam. Using a cross-sectional facility-based survey in 9 provinces, a sample of 582 clients across 18 ART facilities representatives of all facilities where SHI-financed ART was being implemented were interviewed in 2019. Results indicated 13.4% (95% CI: 5.7%, 28.2%) of clients incurred a payment for outpatient ART care. The average out of pocket expenditures for outpatient visits and HIV related outpatient visits was USD $71.2 and $8 per year, respectively. The average out of pocket expenditure for inpatient admission and HIV related inpatient admission was $7.1 and $1.6, respectively. Only 0.1% clients currently experienced HIV-related catastrophic payment at the 25% of total expenditures threshold. The study confirms the transition from donor-financed ART to SHI-financed ART is not causing financial hardship for ART clients. However, more commitment from the Government of Vietnam to strengthen HIV-related services under SHI may be needed in the future, and there is still need to ensure universal SHI coverage among people with HIV/AIDs in Vietnam.
23
Obafemi, Frances Susan, Olanrewaju Olaniyan, and Frances Ngozi Obafemi. "Equity in Health Care Expenditure in Nigeria." International Journal of Finance & Banking Studies (2147-4486) 2, no. 3 (July 21, 2013): 76–88. http://dx.doi.org/10.20525/ijfbs.v2i3.155.
Full textAbstract:
Equity is one of the basic principles of health systems and features explicitly in the Nigerian health financing policy. Despiteacclaimed commitment to the implementation of this policy through various pro-poor health programmes and interventions,the level of inequity in health status and access to basic health care interventions remain high. This paper examines theequity of health care expenditure by individuals in Nigeria. The paper evaluated equity in out-of-pocket spending (OOP) forthe country and separately for the six geopolitical zones of the country. The methodological framework rests on KakwaniProgressivity Indices (KPIs), Reynold-Smolensky indices and concentration indices (CIs) using data from the 2004 Nigerian National Living Standard Survey (NLSS) collected by the National Bureau of Statistic. The results reveal that health financing is regressive with the incidence disproportionately resting on poor households with about 70% of the total expenditure on health being financed through out-of-pocket payments by households. Poor households are prone to bear most of the expenses in the event of any health shock. The catastrophic consequences thus push some into poverty, and aggravate the poverty of others. The paper therefore suggests that the country’s health financing systems must be such that allows people to access services when they are needed, but must also protect household, from financial catastrophe, by reducing OOP spending through risk pooling and prepayment schemes within the health system.
24
Prasov, Oleksandr, and Yuliia Abakumova. "PROCEDURE AND PROBLEMS OF FINANCING PROVISION OF HEALTH CARE TO THE IMPRISONED PERSONS." Baltic Journal of Economic Studies 6, no. 3 (August 5, 2020): 114–23. http://dx.doi.org/10.30525/2256-0742/2020-6-3-114-123.
Full textAbstract:
The purpose of the paper is a study of economic and legislative problems in financing the provision of health care to the imprisoned persons, exercising their right to health care and providing proposals to fill existing gaps in the legislation. Methodology. The survey is based on an analysis of the development of the regulatory framework for health care and the principles of financing health care in some European and post-Soviet countries. A general description of the principles of financing the health care system in the European countries is given. The principles of expenditures on health care financing in relation to public and private expenditures and basic models of health care financing are analyzed. The current state of the health care system and the problems and features of providing health care to imprisoned persons in the post-Soviet territory, in particular in Ukraine, Armenia, the Russian Federation, in the Republics of Kazakhstan, Belarus, Uzbekistan, is studied. The problems of provision, realization and ensuring the right to health care to persons who are in the institution of execution of penalties are considered. An analysis of the regulatory framework governing the issue of the right to health care and the procedure for its implementation. Ways to solve problems related to the exercise of the right to health care for prisoners are proposed. Proposals for improving the regulatory framework in the health care sector on the harmonization of legislative acts (regulations governing the general principles of health care and the provision of health care for the imprisoned persons) are presented. Results. In the process of studying the state policy on financing the provision of health care to the citizens in the European and post-Soviet countries and based on the analysis of the modern legal framework, the need to reform the health care system is justified since only public financing of health care, or a larger percentage (over 80%) of such financing cannot provide all the necessary needs of the health care system. The need to harmonize the legislation of the post-Soviet countries is emphasized in accordance with the international standards. It is concluded that in most post-Soviet countries, the imprisoned persons have the opportunity to implement the legislation on financing and guarantees of health care, but taking into account their legal status and the regime of serving the sentence. Practical implications. Proposals to take into account the health care experience of countries, the achievements of which in the health care sector are recognized by the world community, and which, in addition to public financing of health care, actively turn to other sources, such as social insurance, targeted contributions of the enterprises, etc., are made. Value/originality. The article provides proposals for amendments to the legislation in the health care sector in some post-Soviet countries on the harmonization of legislation governing the general principles of health care and regulations governing the provision of health care to imprisoned persons.
25
KARPYSHYN, Nataliia, and Iryna SYDOR. "Financing of medical services: experience of foreign countries and Ukraine." Economics. Finances. Law, no. 8 (August 28, 2020): 9–13. http://dx.doi.org/10.37634/efp.2020.8.2.
Full textAbstract:
Introduction. Research into the sources of health care funding is necessary to develop an effective policy to improve the domestic health care system and improve the accessibility and quality of medical care. The purpose of the article is to assess the sources of funding of medical services in foreign countries and in Ukraine in order to identify and analise current trends and prospects for financing the domestic health care system in the implementation of health care reform. Results. An analysis of trends in the financing of health services in foreign countries has shown that there is a certain imbalance between the country's economic growth and its health care expenditures. The share of health services expenditures in GDP averaged 8.8 % or almost $ 4,000 per OECD citizen in 2018 y . This cost figure is 24 times higher than the per capita health care costs in Ukraine and can be a guide to the amount of funding for medicine in the world community. Citizens of OECD countries, unlike Ukrainians, pay an average of 21 % of all health care costs. The priority sources of funding for one group of countries are budget funds (Norway, Denmark, Sweden, Great Britain, Canada), and for another – compulsory health insurance (Germany, Japan, France, etc.). Сonclusion. Funds of the population are the main source of funding for medical services in Ukraine – 53 %. This indicator is critical for the country, as low-income citizens are unable to pay for medical care and the number of chronic diseases, disability and mortality are increased. The transformational reform of the health care system in Ukraine was started in 2015 and according to international experts is successful and meets international practices of accessibility, quality and efficiency of medical services. Further consistent implementation of health care reform can provide financial protection for the population from excessive out-of-pocket spending, improve access to health care, and improve public health.
26
Manski, Richard J., Douglas Peddicord, and David Hyman. "Medicaid, Managed Care, and America's Health Safety Net." Journal of Law, Medicine & Ethics 25, no. 1 (March 1997): 30–33. http://dx.doi.org/10.1111/j.1748-720x.1997.tb01393.x.
Full textAbstract:
During the past decade, Medicaid has experienced extraordinary growth, in both number of beneficiaries and total expenditures. Between 1988 and 1993, the number of Medicaid beneficiaries grew from 22 million to 32 million. While the number of Medicaid beneficiaries increased by 45 percent, expenditures increased by 145 percent, from 51 billion to 125 billion. Expressed in terms of its percentage of state budgets, Medicaid doubled from 10 percent to 20 percent over the same time period, to the point that it is currently the second largest budget item for most states.Faced with unsustainable rates of program budget growth and serious concerns about the level of access and the continuity of care afforded by the Medicaid program, states have turned to managed care. Almost every state has introduced some form of managed care for a subset of their Medicaid beneficiary population. Twenty-three states have gone farther, and implemented, proposed, or are developing section 1115 waivers to overhaul their Medicaid programs. These waivers allow states to develop and introduce nonstandard approaches to benefits, eligibility, service delivery, and financing for the Medicaid beneficiary population.
27
Risko, Nicholas, Amit Chandra, Taylor W. Burkholder, Lee A. Wallis, Teri Reynolds, Emilie J. Calvello Hynes, and Junaid Razzak. "Advancing research on the economic value of emergency care." BMJ Global Health 4, Suppl 6 (July 2019): e001768. http://dx.doi.org/10.1136/bmjgh-2019-001768.
Full textAbstract:
Emergency care and the emergency care system encompass an array of time-sensitive interventions to address acute illness and injury. Research has begun to clarify the enormous economic burden of acute disease, particularly in low-income and middle-income countries, but little is known about the cost-effectiveness of emergency care interventions and the performance of health financing mechanisms to protect populations against catastrophic health expenditures. We summarise existing knowledge on the economic value of emergency care in low resource settings, including interventions indicated to be highly cost-effective, linkages between emergency care financing and universal health coverage, and priority areas for future research.
28
KASHNER, T. MICHAEL. "Research Issues Related To Oral Health Expenditures and Financing Oral Health Care for the Aging Veteran." Medical Care 33, Supplement (November 1995): NS90—NS105. http://dx.doi.org/10.1097/00005650-199511001-00010.
Full text
29
Agorinya, Isaiah Awintuen, Maxwell Dalaba, Nathan Kumasenu Mensah, Samuel Tamti Chatio, Lan My Le, Yadeta Dassie Bacha, Jemima Sumboh, et al. "Challenges and experiences in linking community level reported out-of-pocket health expenditures to health provider recorded health expenditures: Experience from the iHOPE project in Northern Ghana." PLOS ONE 16, no. 9 (September 7, 2021): e0256910. http://dx.doi.org/10.1371/journal.pone.0256910.
Full textAbstract:
Out of pocket health payment (OOPs) has been identified by the System of Health Accounts (SHA) as the largest source of health care financing in most low and middle-income countries. This means that most low and middle-income countries will rely on user fees and co-payments to generate revenue, rationalize the use of services, contain health systems costs or improve health system efficiency and service quality. However, the accurate measurement of OOPs has been challenged by several limitations which are attributed to both sampling and non-sampling errors when OOPs are estimated from household surveys, the primary source of information in LICs and LMICs. The incorrect measurement of OOP health payments can undermine the credibility of current health spending estimates, an otherwise important indicator for tracking UHC, hence there is the need to address these limitations and improve the measurement of OOPs. In an attempt to improve the measurement of OOPs in surveys, the INDEPTH-Network Household out-of-pocket expenditure project (iHOPE) developed new modules on household health utilization and expenditure by repurposing the existing Ghana Living Standards Survey instrument and validating these new tools with a ‘gold standard’ (provider data) with the aim of proposing alternative approaches capable of producing reliable data for estimating OOPs in the context of National Health Accounts and for the purpose of monitoring financial protection in health. This paper reports on the challenges and opportunities in using and linking household reported out-of-pocket health expenditures to their corresponding provider records for the purpose of validating household reported out-of-pocket health expenditure in the iHOPE project.
30
Khatri, JR, and Xiao Shuiyuan. "Health care financing in China prior to health reform 2009." Janaki Medical College Journal of Medical Science 1, no. 2 (December 5, 2013): 46–64. http://dx.doi.org/10.3126/jmcjms.v1i2.9270.
Full textAbstract:
Background and Objectives: The health system of China in 1970 was an exemplary model to the world but it began deteriorating after the economic reform in 1980. In order to address the deteriorating health system, government of China implemented the ambitious health reform program in 2009, with the aim to provide “safe, effective, convenient and affordable” health service to all people by 2020. In this study we try gain more insight about the health financing system of China prior to health system reform 2009. Methodology: Secondary data were collected from online data sets of World Health Organization (WHO), World Bank, Economic Co-operation and Development (OECD) and from publicly available reports and documents of related Ministries, and other published sources. Analysis was done with descriptive approach, focused on the three dimensions of health, namely the financing system: total health expenditure, financing source and financing scheme/agents. Results: China’s total health expenditure (THE) from 1995 to 2008 remained below 5% of GDP. From 1995 to 2001, the Government share on health expenditure decreased continuously and reached the lowest level of 36.4 % in 2001. Private financing was the primary funding mechanism and sources of revenue for private financing were private insurance and out-of-pocket payments. Household spending on health has increased with an average growth rate of 11.5 % from 2000 to 2008. Health financing scheme was social insurance type with fragmented risk pooling. Conclusions: Low level of public funding and heavy reliance on out-of-pocket payment were the major problem in the past decades. Hence the daunting problem of inadequate health financing ruled the last three decade of China health system. Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (2): 46-64 DOI: http://dx.doi.org/10.3126/jmcjms.v1i2.9270
31
Asyary, Al. "INDONESIAN PRIMARY CARE THROUGH UNIVERSAL HEALTH COVERAGE SYSTEMS: A FEELING IN BONES." Public Health of Indonesia 4, no. 3 (September 10, 2018): 138–45. http://dx.doi.org/10.36685/phi.v4i3.200.
Full textAbstract:
Jaminan Kesehatan Nasional or JKN realized as the one of problem solving for equity of healthcare in Indonesian setting. At the same point, it has to compatible with all aspects in health financing issues by its newly adopted systems. This review aims to reveal JKN health financing policy since it implemented by 2014 in Indonesia. Several bibliographies databases were identified to conduct literature reviews that comprised of international and national/local journals. It founds that JKN principles focuses on mutual support, not-for-profit, good governance, and portability aspects. JKN enrollment consisted of two types polisholders including incapable polis insurance (PBI JKN) that bear by the Indonesian government, and capable polis insurance (none PBI JKN). JKN have to synergize with recent existing challenges including integration from previous regional health insurance (Jamkesda), healthcare facilities, package benefit, financing issue as well as the deficit issue which happened as lower dues that making by JKN polisholder than the high claim by the healthcare facilities particularly in hospitals. Although, JKN emerges to tackle the inequity of healthcare in all Indonesian regions, the existing settled Jamkesda in several regions, particularly regions with high regional income, made JKN integration as the setback health financing on its regions. Limited healthcare facilities that cooperated with BPJS-Kesehatan also challenged the JKN implementation as well as financial lose in affecting by mismatch between medical expenditures with JKN claimed as per package. It concludes that the political willing to choose several options including to prevent JKN deficit depend on the leader commitment to make JKN as not for another journey but it shall be the destination for health financing in Indonesia.
32
Parish, Susan L., Kathleen C. Thomas, Roderick Rose, Mona Kilany, and Paul T. Shattuck. "State Medicaid Spending and Financial Burden of Families Raising Children with Autism." Intellectual and Developmental Disabilities 50, no. 6 (December 1, 2012): 441–51. http://dx.doi.org/10.1352/1934-9556-50.06.441.
Full textAbstract:
Abstract We examined the association between state Medicaid spending for children with disabilities and the financial burden reported by families of children with autism. Child and family data were from the 2005–2006 National Survey of Children with Special Health Care Needs (n = 2,011 insured children with autism). State characteristics were from public sources. The 4 outcomes included any out-of-pocket health care expenditures during the past year, expenditure amount, expenditures as a proportion of family income, and whether additional income was needed to care for a child. We modeled the association between state per capita Medicaid spending for children with disabilities and families' financial burden, controlling for child, family, and state characteristics. Overall, 78% of families raising children with autism had health care expenditures for their child for the prior 12 months; 42% reported expenditures over $500, with 34% spending over 3% of their income. Families living in states with higher per capita Medicaid spending for children with disabilities were significantly less likely to report financial burden. There is a robust relationship between state Medicaid spending for children with disabilities and the financial burdens incurred by families raising children with autism.
33
Weinberger, Michelle, Nicole Bellows, and John Stover. "Estimating private sector out-of-pocket expenditures on family planning commodities in low-and-middle-income countries." BMJ Global Health 6, no. 4 (April 2021): e004635. http://dx.doi.org/10.1136/bmjgh-2020-004635.
Full textAbstract:
IntroductionThe role of the private sector in family planning (FP) is well studied; however, few efforts have been made to quantify the role of private out-of-pocket (OOP) expenditures on FP commodities across low-and-middle-income countries (LMICs). Calculating OOP expenditures is important to illuminate the magnitude of these contributions and to inform discussions on how financial burdens can be reduced.MethodsEstimates of FP users and commodities consumed by women getting their FP methods from the private sector were made for 132 LMICs. Next, unit price data were compiled from to estimate the average price of commodities in the private sector at both a commercial and subsidised price point. These unit prices were applied to commodity consumption estimates to calculate total private OOP expenditures. Sensitivity testing was conducted.ResultsTotal estimated private OOP expenditures for FP commodities in 2019 was $2.73 billion across 132 LMICs. Spending on contraceptive pills accounted for 80% of this total, and just over three-quarters of expenditure came from upper-middle-income countries. OOP expenditures on subsidised commodities were small but accounted for 20% of expenditures in low-income countries. Non-subsidised unit prices were found to be between 5 and 20 times higher in upper-middle-income countries compared with low-income countries, although wide variation exists. For low-income and lower-middle-income countries, subsidies appear to be greatest for intrauterine devices (IUDs) and pills.ConclusionLarge OOP expenditures across all income levels highlight a need for financing approaches that ensure that a wide range of contraceptives are both accessible and affordable.
34
Hsiao, William C. "Correcting Past Health Policy Mistakes." Daedalus 143, no. 2 (April 2014): 53–68. http://dx.doi.org/10.1162/daed_a_00272.
Full textAbstract:
China's health policy in the 1980s followed its economic policy of marketization. China shifted health financing from public to private and commercialized the country's public health services. Unwittingly, the Chinese government did not grasp the serious market failures in health care, which resulted in a profit-driven public health service in which patients pay directly for services. China's health policy created three major unintended consequences: disparity between rural and urban residents, poor quality of health care, and rapid inflation in health expenditures. Since 2003, China has tried to correct its policy mistakes through public financing and by establishing social health insurance. However, strong profit motives have become embedded within the culture of medical professionals and have eroded the professional ethics that prioritize medical practices for patients' benefits. Restoring medical ethics is a formidable challenge. This paper analyzes the transformation of the Chinese health system and its ongoing challenges.
35
Parish, Susan, Kathleen Thomas, Roderick Rose, Mona Kilany, and Robert McConville. "State Insurance Parity Legislation for Autism Services and Family Financial Burden." Intellectual and Developmental Disabilities 50, no. 3 (June 1, 2012): 190–98. http://dx.doi.org/10.1352/1934-9556-50.3.190.
Full textAbstract:
Abstract We examined the association between states' legislative mandates that private insurance cover autism services and the health care–related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N = 2,082 children with autism). State policy characteristics were taken from public sources. The 3 outcomes were whether a family had any out-of-pocket health care expenditures during the past year for their child with autism, the expenditure amount, and expenditures as a proportion of family income. We modeled the association between states' autism service mandates and families' financial burden, adjusting for child-, family-, and state-level characteristics. Overall, 78% of families with a child with autism reported having any health care expenditures for their child for the prior 12 months. Among these families, 54% reported expenditures of more than $500, with 34% spending more than 3% of their income. Families living in states that enacted legislation mandating coverage of autism services were 28% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. Families living in states that enacted parity legislation mandating coverage of autism services were 29% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. This study offers preliminary evidence in support of advocates' arguments that requiring private insurers to cover autism services will reduce families' financial burdens associated with their children's health care expenses.
36
Thakur, Kanchan, Raveen ., Sita ., Suresh Kumar, Vineeta Sharma, Shankar Prinja, and Sushma Kumari Saini. "Assessment of health problems and healthcare expenditure, utilization of healthcare schemes and insurances among residents of Dhanas UT Chandigarh." International Journal Of Community Medicine And Public Health 8, no. 5 (April 27, 2021): 2279. http://dx.doi.org/10.18203/2394-6040.ijcmph20211746.
Full textAbstract:
Background: Non-communicable diseases account for high burden of morbidity and mortality all over the world. Increased burden and need of long-lasting medical care pose adverse financial implications on poor households. It becomes even more difficult in the absence of any financial risk protection (FRP). In that case the families are forced to manage health care expenditures from the money needed for their routine daily expenses thus increasing Out of pocket expenditures. Objective of the study was to assess the morbidity burden, and out of pocket (OOP) expenditure on healthcare; assess the utilization of health care insurance schemes.Methods: A cross-sectional study was conducted among the residents of Dhanas Village Chandigarh using systematic random sampling technique. Data was collected by interviewing the participants as per interview schedule on disease patterns, OOP expenditures, and coping methods used for incurring health care expenses. From total 419 selected families, one adult member from each family was interviewed at their own house setting.Results: A low insurance coverage (20.5%) was reported and among insured 66.2% had availed benefits. The illness rate was found to be 14.2% and hospitalization rate was 3.7%. The endocrinal disorders were most prevalent among the residents. One third (36.5%) of households had faced catastrophic expenditure for outpatient and 10% for the inpatient care. The salary was leading source of expenditure.Conclusions: There is low insurance coverage and high catastrophic expenditure among the households.
37
Ikegami, Naoki. "Financing Long-term Care: Lessons From Japan." International Journal of Health Policy and Management 8, no. 8 (May 29, 2019): 462–66. http://dx.doi.org/10.15171/ijhpm.2019.35.
Full textAbstract:
Long-term care (LTC) must be carefully delineated when expenditures are compared across countries because how LTC services are defined and delivered differ in each country. LTC’s objectives are to compensate for functional decline and mitigate the care burden of the family. Governments have tended to focus on the poor but Germany opted to make LTC universally available in 1995/1996. The applicant’s level of dependence is assessed by the medical team of the social insurance plan. Japan basically followed this model but, unlike Germany where those eligible may opt for cash benefits, they are limited to services. Benefits are set more generously in Japan because, prior to its implementation in 2000, health insurance had covered long-stays in hospitals and there had been major expansions of social services. These service levels had to be maintained and be made universally available for all those meeting the eligibility criteria. As a result, efforts to contain costs after the implementation of the LTC Insurance have had only marginal effects. This indicates it would be more efficient and equitable to introduce public LTC Insurance at an early stage before benefits have expanded as a result of ad hoc policy decisions.
38
Gajic-Stevanovic, Milena, Nevenka Teodorovic, Snezana Dimitrijevic, and Dragan Jovanovic. "Assessment of financial flow in the health system of Serbia in a period 2003-2006." Vojnosanitetski pregled 67, no. 5 (2010): 397–402. http://dx.doi.org/10.2298/vsp1005397g.
Full textAbstract:
Background/Aim. The main goal of every health policy is not merely the establishment of the health system sustainability, but the accessibility of health services to the whole population, as well. This objective is shared in European Union countries, and the consequence is the implementation of National Health Accounts (NHA). NHA, as a tool for evidence-based management, provides data regarding financial flow in health at national level and alows international comparability. The aim of this study was to determine Serbian overall health spending patterns by National Health Accounts, and to determine health care indices to provide policy makers with internationally comparable health indicators. Methods. A retrospective analysis of healthcare expenditures was obtained from the published final financial reports of relevant state institutions during a period of 2003 to 2006. The various sources of data on healthcare expenditures were connected according to instructions by the OECD 'A System of Health Accounts (SHA)' Version 1.0. Results. The obtained results showed: health expenditures in Serbia made up 8.6%, 8.3%, 8.7% and 9 % of the GDP in 2003, 2004, 2005 and 2006, respectively; the Health Insurance Fund was a predominant financing source of the public sector with 93% in 2006; the largest part of the total health expenditures went towards hospitals and for health services; the expenditure per capita in 2006 was 365 US$; Serbian population finances the state institutions 'out of pocket' with 21.28% of their sources, which was 7.3% of the total healthcare expenditures, and the private institutions with 78.72% of their financial sources, which is 27% of the total healthcare expenditures. In 2006 Serbia allocated financial resources out of GDP in the amount similar to the European Unity, while comparing to the countries of the region, these funds were less only than in Bosnia and Herzegovina. This allocating of financial resources in total, however, was low as the consequence of relatively low level of GDP in Serbia. Conclusion. Establishing NHA provided a pattern of national healtcare spending and allowed a comparison of healthcare system in Serbia with the systems of other countries. Analysing a period 2003- 2006 revealed a similarity between Serbia and the countries of the European Unity in regard to the level of average financial resources allocation for healthcare expressed as a percentage of GDP, as well as in regard to financiers in the system of healthcare. A high purchasing power disparity, however, in healthcare services was observed between the population of Serbia and other European countries.
39
Budarin, S. S., D. O. Vatolin, and Iu V. Elbek. "Cross-Country Analysis of Funding Models of Medical Organizations in the Context of the COVID-19 Pandemic." MGIMO Review of International Relations 13, no. 5 (November 11, 2020): 352–74. http://dx.doi.org/10.24833/2071-8160-2020-5-74-352-374.
Full textAbstract:
Abstract: The COVID-19 coronavirus infection has made significant adjustments to the management of the health care system, both in Russia and abroad. Different models of financing health systems in different ways responded to the management in emergency situations. According to experts, systems with a state-based socially oriented model of health care were more effective. At the same time, opinions were divided on the effectiveness of the insurance model for financing medical organizations that provide different types of medical care to the population. The article analyzes measures to provide medical organizations with financial and material and technical resources in countries with different economic models of the health system, and on the example of outpatient clinics in Moscow, compares changes in the main financial indicators in the first half of 2020 and assesses the financial stability of medical organizations during the period of restrictions on preventing the spread of COVID-19 coronavirus infection. The hypothesisis that financial condition of polyclinics during the period of restrictions has improved. It is based on the assumption that declining number of visits to medical organizations reduces the level of organizations’ expenditures while maintaining the volume of their income at almost the same level due to the principle of per capita state financing of medical organizations that provide outpatient medical care. Based on the results of the analysis, it is concluded that the financial stability of adult polyclinics is maintained and the financial stability of children's polyclinics is increased.
40
Leiter, Andrea M., and Engelbert Theurl. "Determinants of prepaid systems of healthcare financing: a worldwide country-level perspective." International Journal of Health Economics and Management 21, no. 3 (March 31, 2021): 317–44. http://dx.doi.org/10.1007/s10754-021-09301-w.
Full textAbstract:
AbstractIn this paper we examine determinants of prepaid modes of health care financing in a worldwide cross-country perspective. We use three different indicators to capture the role of prepaid modes in health care financing: (i) the share of total prepaid financing as percent of total current health expenditures, (ii) the share of voluntary prepaid financing as percent of total prepaid financing, and (iii) the share of compulsory health insurance as percent of total compulsory prepaid financing. In the econometric analysis, we refer to a panel data set comprising 154 countries and covering the time period 2000–2015. We apply a static as well as a dynamic panel data model. We find that the current structure of prepaid financing is significantly determined by its different forms in the past. The significant influence of GDP per capita, governmental revenues, the agricultural value added, development assistance for health, degree of urbanization and regulatory quality varies depending on the financing structure we look at. The share of the elderly and the education level are only of minor importance for explaining the variation in a country’s share of prepaid health care financing. The importance of the mentioned variables as determinants for prepaid health care financing also varies depending on the countries’ socio-economic development. From our analysis we conclude that more detailed information on indicators which reflect the distribution of individual characteristics (such as income, family size and structure and health risks) within a country’s population would be needed to gain deeper insight into the decisive determinants for prepaid health care financing.
41
Choi, Sunha. "Experiencing Financial Hardship Associated With Medical Bills and Its Effects on Health Care Behavior: A 2-Year Panel Study." Health Education & Behavior 45, no. 4 (November 8, 2017): 616–24. http://dx.doi.org/10.1177/1090198117739671.
Full textAbstract:
Using 2-year panel data, this study examined (1) whether experiencing financial hardship associated with out-of-pocket medical expenditures affected delaying/missing necessary health care in the following year; (2) whether such financial hardship mediated the effects of predisposing, enabling, and need characteristics on timely health care access (i.e., significant indirect effects); and (3)whether such mediating effects are different by chronic health status (i.e., moderated mediation) among U.S. adults. The 2011 National Health Interview Survey was linked to the 2012 Medical Expenditure Panel Survey. The sample includes 8,993 adults aged between 26 and 64 years. Among them, 1,089 reported having at least one chronic health condition that had caused activity limitations. Multiple-group path analysis was conducted using Mplus 7.2. Approximately 35% experienced financial difficulties paying medical bills, including 28% who were currently paying off medical debts. Almost 14% of the respondents reported delayed/missed necessary medical treatments. In addition to direct effects, predisposing, enabling, and need factors affected access to care indirectly via financial hardship, although significant moderated mediation was found by chronic health status. However, different from the Andersen’s behavioral model of health service utilization, the effect of financial hardship due to medical bills as a barrier to the timely use of necessary health services was not smaller among adults with chronic health conditions. Policy alternatives should be explored to provide affordable financing programs and adequate safety net health services to reduce the financial burden of health care for those who are financially vulnerable, especially those suffering from chronic health conditions.
42
Kielb, Edward S., Corwin N. Rhyan, and James A. Lee. "Comparing Health Care Financial Burden With an Alternative Measure of Unaffordability." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 54 (January 1, 2017): 004695801773296. http://dx.doi.org/10.1177/0046958017732960.
Full textAbstract:
Health insurance plans with high deductibles increase exposure to health care costs, raising concerns about how the growth in these plans may be impacting both the financial burden of health care expenditures on families and their access to health care. We find that foregoing medical care is common among low-income, privately insured families, occurring at a greater rate than those with higher incomes or Medicare coverage. To better understand the relationship between out-of-pocket (OOP) spending and access, we used the 2011-2014 Medical Expenditure Panel Survey (MEPS) data and a logistic model to analyze the likelihood of avoiding or delaying needed medical care based on health insurance design and other individual and family characteristics. We find that avoiding or delaying medical care is strongly correlated with coverage under a high-deductible health plan, and with depression, poor perceived health, or poverty. However, it is relatively independent of the percent of income spent on OOP costs, making the percent of income spent on OOP costs by itself a poor measure of health care unaffordability. Individuals who spend a small percentage of their income on health care costs may still be extremely burdened by their health plan when financial concerns prevent access to health care. This work emphasizes the importance of insurance design as a predictor of access and the need to expand the definition of financial barriers to care beyond expenditures, particularly for the low-income, privately insured population.
43
Nayeri, Kamran. "Economic Boundaries of Health Policy: Factors Influencing 1993–1994 Reform Proposals." International Journal of Health Services 26, no. 4 (October 1996): 709–30. http://dx.doi.org/10.2190/55nk-r6fv-lvwu-tklw.
Full textAbstract:
This article offers a theoretical framework for understanding the crisis of the U.S. health care system and the mainstream debate on restructuring health care financing and delivery subsystems. The author argues that the crisis of the health care system is a cause and a consequence of the long cycle of structural changes in the U.S. economy since World War II. The article distinguishes between the level and the rate of growth of health care expenditures. It is possible to moderate the level of health care expenditure by adopting measures in the direction indicated by the historical experience of other advanced capitalist economies. However, in the long term the rate of growth of health care costs will exceed the rate of growth of gross domestic product, thus any attempt to limit it will result in deterioration in the quantity and quality of health care services. The 1993–1994 mainstream debate is revisited to show how these proposals were a part of the overall effort to resolve the long-term problems of the U.S. economy. The defeat of the Clinton plan was due to its concerns with efficiency of the health care system in the face of the demand by a majority of the U.S. capitalist class to cut costs.
44
Schicke, R. K. "Trends in the Diffusion of Selected Medical Technology in the Federal Republic of Germany." International Journal of Technology Assessment in Health Care 4, no. 3 (July 1988): 395–405. http://dx.doi.org/10.1017/s0266462300000350.
Full textAbstract:
AbstractThis article contends that the German social and economic situation is conducive to the rapid diffusion of innovative medical technology. While there is public control over hospital facilities, the pluralistic health care system and decentralized government responsibilities contribute to an essentially laissez faire regulatory environment. There is perfunctory planning and regulation for major medical expenditures, but the essential constraints are financial. This is no comprehensive program for the assessment of diagnostic technologies and the effective imposition of guidelines depends on the cooperative effort of various financing organizations, professional interests, and public pressure groups.
45
Yadav, Jeetendra, Denny John, Geetha R. Menon, and Shaziya Allarakha. "Out-of-Pocket Payments for Delivery Care in India: Do Households face Hardship Financing?" Journal of Health Management 23, no. 2 (June 2021): 197–225. http://dx.doi.org/10.1177/09720634211011552.
Full textAbstract:
Background: Present study aims to examine the socioeconomic and demographic factors that affect health care utilization, health care expenditure and financing strategies for delivery care in India. Methods: The study uses data from National Family Health Survey (NFHS-4), 2015-2016. Descriptive, bivariate and multivariate regression analysis were carried out to examine health care utilization, out of pocket expenditure and financing strategies for delivery care in India. We used hardship financing as when people resort to borrowings, or sale of property/jewelry to pay for healthcare expenditure Results: Overall, Janani Suraksha Yojana (JSY) could cover less than 40% of the delivery care expenditure across all states. One-third of the households borrowed money or sold property/jewelry for delivery care expenditure. Highest exposure to hardship financing was observed in utilisation of private healthcare facilities for delivery. Women from the higher income quintiles are less likely to experience hardship financing as compared to women from the poorest wealth quintile. Conclusions: The study results will be useful for government to ensure that financing policies for delivery such as JSY are effective to provide availability and affordability of delivery healthcare in India.
46
Noy, Shiri, and Patricia A. McManus. "Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean." Sociology of Development 1, no. 2 (2015): 113–39. http://dx.doi.org/10.1525/sod.2015.1.2.113.
Full textAbstract:
Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.
47
Noy, Shiri, and Patricia A. McManus. "Modernization, Globalization, Trends, and Convergence in Health Expenditure in Latin America and the Caribbean." Sociology of Development 1, no. 2 (2015): 321–46. http://dx.doi.org/10.1525/sod.2015.1.2.321.
Full textAbstract:
Are health care systems converging in developing nations? We use the case of health care financing in Latin America between 1995 and 2009 to assess the predictions of modernization theory, competing strands of globalization theory, and accounts of persistent cross-national differences. As predicted by modernization theory, we find convergence in overall health spending. The public share of health spending increased over this time period, with no convergence in the public-private mix. The findings indicate robust heterogeneity of national health care systems and suggest that globalization fosters human investment health policies rather than neoliberal, “race to the bottom” cutbacks in public health expenditures.
48
Wielechowski, Michał, and Łukasz Grzęda. "HEALTH CARE FINANCING IN THE EUROPEAN UNION COUNTRIES – STRUCTURE AND CHANGES." Acta Scientiarum Polonorum. Oeconomia 19, no. 1 (March 12, 2020): 71–80. http://dx.doi.org/10.22630/aspe.2020.19.1.8.
Full textAbstract:
The aim of the paper was to present health care systems and assess the recent trend in health care expenditure in the European Union countries. The data source was the World Bank and European Statistical Office (Eurostat). The adopted research period covered the years 2000–2016, due to data availability. The methodology of the study was based on an analysis of data indicator series related to health care expenditure, which evaluate the national health care system performance. The research results were presented using primarily Japanese candlestick charting. The study showed that health care expenditure represented an ever-increasing burden for all the EU economies, both in absolute values and in relation to GDP. However, substantial differentiations in the amount and structure of health care expenditure were observed at the country level, having roots in the level of a country’s economic development and diverse post-war economic and political evolution. The analysis of health care expenditure structure confirmed that all three types of health care systems (Beveridge, Bismarck and mixed one) were observed in the EU, but the last one had a marginal importance. The form of system did not determine its effectiveness. On average, more than three-fourths of health care expenses were financed by general government expenditure. Out-of-pocket spending varied widely among the analysed EU member states.
49
Zeckhauser, Richard. "Public Finance Principles and National Health Care Reform." Journal of Economic Perspectives 8, no. 3 (August 1, 1994): 55–60. http://dx.doi.org/10.1257/jep.8.3.55.
Full textAbstract:
Public finance principles, though usually treated as a minor consideration, lie at the heart of effective national health care reform. Four principles are discussed: charge for a service where its cost is created; distinguish rents, resources, and transfers; know what services cost and pay accordingly; balance distributional and equity concerns. The principles’ implications include: since employment does not much affect health costs, financing (particularly of incremental insureds) need not be employer-based; health resources being immobile, many cutbacks in expenditure will not reflect real resource savings; and health care financing should mesh with an overall program of taxation and expenditure.
50
Kovač, Nevenka, and Šime Smolić. "Private health care sector in Croatia." Ekonomski pregled 72, no. 4 (2021): 619–39. http://dx.doi.org/10.32910/ep.72.4.6.
Full textAbstract:
This paper investigates the trends in business activity of the private health care sector in Croatia from 2011 to 2018. Databases of Croatian provider of financial and electronic services - Financial Agency (FINA) - have been employed to explore key performance indicators of private health care sector companies, in particular trends in total employment, business revenues and operating profits. In addition, the most important features of voluntary health insurance (VHI) provided by private health insurance companies and the Croatian Health Insurance Fund (HZZO) have been presented. Furthermore, this paper provides both a relevant analysis of the private health care sector as well as private spending on health care in Croatia. The results indicate that users of health care services are willing to pay more to gain faster access and higher quality services. In 2018, expenditures for private health care services reached almost HRK 5 billion. Nearly 60% were out-of-pocket (OOP) payments and 40% were paid through the VHI. Despite the persistent recession, the private health care sector in Croatia experienced an average annual growth rate of 10% in the analysed period. More recently, the trend of introduction of more complex services within private providers can be observed indicating the rise in investments, and competitiveness. In conclusion, private health care sector’s presence in Croatia is a reality that should be addressed adequately. Original findings in this paper might serve as starting point for future discussions regarding the private health care sector role in the overall health care system financing. The paper brings a deeper insight into Croatian private health care sector market using original and most recent microdata thus shedding the light on important part of our health economy. Nevertheless, paper has certain limitations that are mainly reflected in relatively narrow set of indicators used in private health care sector business analysis. This though might be addressed properly in future research.