Model Of Health Care Financing Research Articles

Efficiency of Healthcare Financing: Case of European Countries

Global turbulence and uncertainty force civil servants and executors to optimise public finance distribution. The COVID-19 pandemic aligned with the necessity of assessing the efficiency of healthcare financing due to its capability in overcoming the negative consequences. The paper analyses the peculiarities of healthcare financing in 34 European countries and points out trends and changes in its structure and dynamics. It also realises cluster analysis to reveal models of healthcare financing and their specific features. Panel data regression analysis was used to assess the efficiency of healthcare financing within each cluster by clarifying the relationship between healthcare expenditures and public health outcome—life expectancy. The distributed lag model was also used to test for time lags between financial inflows in healthcare and its outcome. Empirical results highlight key tips for optimising healthcare financing and creating the benchmark model.

Predicting healthcare expenditure based on Adjusted Morbidity Groups to implement a needs-based capitation financing system

BackgroundDue to population aging, healthcare expenditure is projected to increase substantially in developed countries like Spain. However, prior research indicates that health status, not merely age, is a key driver of healthcare costs. This study analyzed data from over 1.25 million residents of Spain's Murcia region to develop a capitation-based healthcare financing model incorporating health status via Adjusted Morbidity Groups (AMGs). The goal was to simulate an equitable area-based healthcare budget allocation reflecting population needs.MethodsUsing 2017 data on residents' age, sex, AMG designation, and individual healthcare costs, generalized linear models were built to predict healthcare expenditure based on health status indicators. Multiple link functions and distribution families were tested, with model selection guided by information criteria, residual analysis, and goodness-of-fit statistics. The selected model was used to estimate adjusted populations and simulate capitated budgets for the 9 healthcare districts in Murcia.ResultsThe gamma distribution with logarithmic link function provided the best model fit. Comparisons of predicted and actual average costs revealed underfunded and overfunded areas within Murcia. If implemented, the capitation model would decrease funding for most districts (up to 15.5%) while increasing it for two high-need areas, emphasizing allocation based on health status and standardized utilization rather than historical spending alone.ConclusionsAMG-based capitated budgeting could improve equity in healthcare financing across regions in Spain. By explicitly incorporating multimorbidity burden into allocation formulas, resources can be reallocated towards areas with poorer overall population health. Further policy analysis and adjustment is needed before full-scale implementation of such need-based global budgets.

Problems and ways to improve the efficiency of the Kazakhstani model of health care financing based on CHI

Problems and ways to improve the efficiency of the Kazakhstani model of health care financing based on CHI

Some Issues of the healthcare financing model

Some Issues of the healthcare financing model

Potential demand for National Health Insurance in Zimbabwe: Evidence from selected urban informal sector clusters in Harare.

Zimbabwe's tax-based healthcare financing model has been characterised by perennial financing deficits and widespread application of user fees and has thus been socially exclusive. The country's urban informal sector population is not spared from these challenges. The study explored the potential demand for National Health Insurance (NHI) among respondents from selected urban informal sector clusters of Harare. The following clusters were targeted: Glenview furniture complex, Harare home industries, Mupedzanhamo flea market, Mbare new wholesale market and Mbare retail market. A cross-sectional survey was administered to 388 respondents from the selected clusters, and data on the determinants of Willingness to Join (WTJ) and Willingness to Pay (WTP) was gathered. Respondents were recruited via a multi-stage sampling procedure. In the first stage, the five informal sector clusters were purposely selected. The second stage involved a proportional allocation of respondents by cluster size. Finally, based on the stalls allocated by municipal authorities in each area, respondents were selected using systematic sampling. The sampling interval (k) was determined by dividing the total number of allocated stalls in a cluster (N) by the sample size proportionate to that cluster (n). For each cluster, the first stall (respondent) was randomly chosen, and thereafter, a respondent from every 10th stall was selected and interviewed at their workplace. Contingent valuation was adopted to elicit WTP. Logit models and interval regression were applied for the econometric analyses. A total of 388 respondents participated in the survey. The dominant informal sector activity among the surveyed clusters was the sale of clothing and shoes (39.2%), followed by the sale of agricultural products (27.1%). Concerning employment status, the majority were own-account workers (73.1%). Most of the respondents (84.8%) completed secondary school. On monthly income from informal sector activities, the highest frequency (37.1%) was observed in the Zw$(1000 to <3000) or US$(28.57 to <85.71) category. The mean age of respondents was 36 years. Out of the 388 respondents, 325 (83.8%) were willing to join the proposed NHI scheme. WTJ was influenced by the following factors: health insurance awareness, health insurance perception, membership to a resource-pooling scheme, solidarity with the sick, and household recently experiencing difficulties paying for healthcare. On average, respondents were willing to pay Zw$72.13 (approximately US$2.06) per person per month. The key determinants of WTP were household size, respondent's education level, income, and health insurance perception. Since the majority of respondents from the sampled clusters were willing to join and pay for the contributory NHI scheme, it follows that there is potential to implement the scheme for the urban informal sector workers from the clusters studied. However, some issues require careful consideration. The informal sector workers need to be educated on the concept of risk pooling and the benefits of being members of an NHI scheme. Household size and income are factors that require special attention when deciding on the premiums for the scheme. Moreover, given that price instability hurts financial products such as health insurance, there is a need for ensuring macroeconomic stability.

Abstract Number ‐ 191: Barriers to Mechanical Thrombectomy in Africa

Introduction The emergence of mechanical thrombectomy (MT) as a standard of care has revolutionized the management of proximal large vessel occlusions (LVOs) in patients with acute ischemic stroke (AIS). Endovascular therapy has already been shown to provide better long‐term outcomes when compared to standard treatment alone. However, despite the significant advances and benefits associated with MT in the treatment of proximal LVOs in developed countries, Africa continues to lag in the use and adaptability of the “gold standard” for proximal LVO stroke treatment. With the prevalence of stroke in Africa approaching the highest rates in the world, this study seeks to highlight the problems threatening endovascular therapy in Africa. This is an important step in advocacy for more radical, effective, and evidence‐based management of patients with proximal LVOs in Africa. Methods For this narrative review, PubMed and Google Scholar were used to search for literature on mechanical thrombectomy and endovascular treatment of LVOs in Africa. Selection criteria were manuscripts published in the last 10 years, written in English language, and addressed challenges with MT. Results 42 papers from 21 African nations were found and reviewed. The major challenges and impediments to MT in Africa were, a lack of government policy on stroke care, a suboptimal health care financing model that makes endovascular treatment nearly impossible to afford, delay in presenting to the hospital after stroke onset coupled with very few emergency services with some countries having none, lack of specialized training, as well as, scarcity of neuroradiological infrastructure. Conclusions Despite these challenges, there is still hope for Africa. With its four domains (surveillance, prevention, acute treatment, and rehabilitation), the stroke quadrangle, adapted by many countries allows for focused initiatives aimed at successfully lowering the burden of stroke in Africa at the community level through prevention and education. There is still an urgent need for increased global support to address these challenges in Africa, even as programs like the MT2020+ by the Society of Vascular and Interventional Neurology (SVIN) have given Africa hope for the future of endovascular therapy by fostering collaboration, training, and policy development.

ТРАНСФОРМАЦІЯ СИСТЕМИ БЕЗПЕРЕРВНОЇ МЕДИЧНОЇ ОСВІТИ ЛІКАРІВ-СТОМАТОЛОГІВ В УКРАЇНІ

The transformation of the health care system in Ukraine, radical changes in the health care financing model, which were introduced in 2017, led to changes in the system of training doctors and other specialists. The main task of medical education remains to provide citizens with high-quality medical care thanks to the high level of training of specialists. The new strategy of medical education in Ukraine, the rapid pace of development of medical science, the increase in the amount of new information about innovative technologies in the diagnosis, treatment, and prevention of major dental diseases – all this necessitated the search for new forms of continuous professional development of doctors.

НАПРЯМКИ РОЗВИТКУ МЕДИЧНОГО СТРАХУВАННЯ В СИСТЕМІ НАЦІОНАЛЬНОЇ ЕКОНОМІКИ КРАЇНИ

The article examines modern theoretical and practical features of insurance and defines its role and functions in the economy of the state; the place of health insurance in the financing system of the state economy is revealed; a conceptual approach to the organization of health care financing on the basis of medical insurance was developed; analyzed the qualitative and quantitative signs of effective financial support of the healthcare industry by determining the level of its financing in Ukraine; the role of voluntary health insurance as an element of financing the state economy is assessed; the impact of socio-economic factors on the financial potential of the social insurance market is investigated. The degree of development of insurance is an indicator of the maturity of market relations. A well-established insurance system contributes to business development and solving social problems. A conceptual approach to the organization of health care financing based on medical insurance has been introduced, which is complemented by a methodical approach to determining the financial potential of the health insurance market, a mechanism for building an optimal health care financing model, and the stages of implementation of this mechanism, which will contribute to the development of additional sources of financing economy of the state to ensure effective social protection. interests of the population. The model of financing the health care industry based on medical insurance was substantiated, taking into account the key functions of the financial system of the state; a methodical approach to establishing the optimal size of the insurance contribution in the mandatory health insurance system using simulation modeling is proposed; a scientific and methodological approach to the formation of mechanisms for the effective development of medical insurance in the financing system of the country's economy was developed in order to ensure the restoration of its health and working capacity by means of the guarantee and availability of medical services within the framework of mandatory medical insurance and voluntary medical insurance, which complements these guarantees.

The Intersection of Finance and Healthcare: Financing Healthcare Delivery Systems

The Intersection of Finance and Healthcare: Financing Healthcare Delivery Systems" explores the complex relationship between finance and healthcare, focusing on the financing of healthcare delivery systems. The article discusses the importance of effective financial management in healthcare organizations, including budgeting, revenue cycle management, cost containment, and financial reporting. It also examines the role of finance in promoting patient care and saving costs through strategies like accountable care organizations and value-based care models. The article highlights the significance of financing for medical innovation, research, and the creation of novel treatments and cures. The article also discusses the importance of financing for attracting, training, and retaining a competent healthcare workforce. The article emphasizes the significance of sustainable finance in accomplishing universal health coverage and mitigating inefficiencies within the health system. The article examines various healthcare financing models, including tax-funded healthcare systems, social health insurance programs, private health insurance models, and hybrid healthcare finance models. The article also discusses the historical perspectives of healthcare financing, including the creation of publicly funded healthcare systems and the Affordable Care Act. The article concludes by examining the current landscape of healthcare financing, including global trends in healthcare spending and funding schemes. The article emphasizes the importance of balancing clinical efficacy and financial efficiency in healthcare finance systems and overcoming obstacles like fragmentation of services, bureaucratic obstacles, and administrative inefficiencies.

Individual Responsibility Integration in Latvian Health Financing Model – Challenges and Opportunities

Wherewith actualisation of health promotion as an important aspect in the context of public health maintenance, the questions which are connected to public joint responsibility in their health maintenance and improvement attain even greater importance. Taking into consideration the insufficient health quality of Latvian population which ranks Latvia in one of the last places among the European countries, actualisation and implementation of individual responsibility dimension in the health care financing model, is viewed as a possibility of improvement of the current situation. The research overlooked the approaches of individual responsibility integration in health care models employed by the developed countries, classifying those several parameters, established the insufficient Latvian population involvement level which is characterised by large health influencing harmful habit prevalence and low involvement level in illness prevention measures, as well as marked the main challenges and possibilities, introducing individual responsibility dimension in Latvian health care financing model which are referred to both increasing the payment solidarity and lifestyle and behaviour changes.

PRIMARY MEDICINE FUNDING: REALITIES AND PROBLEMS OF IMPLEMENTATION OF THE BRITISH EXPERIENCE IN UKRAINE

Introduction. In Reforming Ukraine’s health care system involves distinguishing between primary, secondary and tertiary levels of health care, as well as determining the list of services to be provided at each of these levels. Ukraine will have to adapt its chosen model of health care financing to national priorities and ensure the availability of health care. Copying any foreign model without taking into account domestic peculiarities and economic justification will inevitably be accompanied by significant risks and will not lead to the expected results. Taking into account the outlined aspects, the issue of implementation of the British experience of financing primary health care in Ukraine is topical. The purpose of the article is to monitor current trends, identify and analyze problems related to the implementation of the British experience in the system of financing primary health care in Ukraine. Results. The study showed that in the process of reforming Ukraine’s health care financing system, primary health care will undoubtedly be a priority for public funding. The process of implementation of the British model of financing PMD, as expected, has created certain difficulties and problems that require systematic scientific analysis and neutralization of the risks of negative impact on social development. It must be acknowledged that the difficulties in implementing PMD reform are a normal world practice, and budgetary constraints on the financing of the primary care system of Ukraine are an incentive for the NHS to target and rationally allocate budget funds. Conclusions. The cornerstone of the “money follows the patient” reform principle has not been implemented at the primary care level. A problematic aspect of the PHC reform is that in 2018–2020 the NSSU did not perform the function of an organization engaged in strategic procurement of quality primary health care services for the benefit of Ukrainian citizens, but acted exclusively as an organization concluding contracts with medical institutions. We consider debatable the expediency of applying the capitation rate, which clearly does not encourage the family doctor to provide the maximum possible amount of medical care to the patient, but creates a “transfer of responsibility” to narrow specialists. In our opinion, in the logistics of PMD reform, the principle of “money follows the patient” should be replaced by the basic financial model of “money follows services”, which demonstrates the fundamental aspects of the new reform paradigm for public procurement of medical services.

Crisis of Capital and the Ongoing Bolsonaro’s Neo-Fascism: The Destructive &amp;lt;i&amp;gt;Continuum&amp;lt;/i&amp;gt; of Public Health via Primary Care

The aim of this article is to update the critical discussion of the public health policies adopted by the Bolsonaro government, particularly with regard to the second year of implementation of the new financing model for Primary Health Care (PHC). The critical analysis is based on a reflection in which the tightening of the restricted legitimacy of the political regime is evident, with its form assumed by ultraneoliberal policies and by the neofascism of the Bolsonaro government. These forms of domination, political and economic, engender an internal conjuncture that aims to remodel the accumulation of capital in public health via PHC through subtle bureaucratic “operational” mechanisms of deconstruction of the financing university. This article is organized in three parts. The first discusses the scope of the triple crisis of capital, sanitary, economic and ecological, and its organic relationship with the State in Brazilian dependent capitalism, allowing space for the growth of the restriction of the political regime endorsed by the rise of neo-fascism. The second addresses the reduction of budgetary resources with the escalating defunding of Health Unified System (SUS). The third part discusses the continued measures and effects in the second year of implementation of the Primary Health Care financing model, evidencing the continuity of the process of valuing an “operational SUS” to the detriment of its principle of universality as the object of an ongoing project associated with the neo-fascist dimension of the Bolsonaro government.

Methodological Features of the Formation of the Model of Healthcare Financing

The situation when, in the context of unsystematic risks caused by the influence of unpredictable factors, there is a need to implement reasonable methods of regulating the state of the health sector, manifested itself in practice during the period of threat to public health. In this regard, the theoretical substantiation of the ways of implementing the functions of healthcare management based on the assessment of the state and stages of development is an urgent area of research. Based on the study of threats to the economic security of the socio-economic system from healthcare in the regions of the Russian Federation, the article examines the main provisions of the theory of life cycles and evaluates the legitimacy of the formulated hypothesis about its applicability to the healthcare financing model. In the article, taking into account the substantiation of the legitimacy of the author's hypothesis about the dependence of the economic security of the socio-economic system on the healthcare financing mechanism, the requirements for the methodological approach to the model for assessing the economic security of the region are proposed. It is shown that on the basis of the implementation of the main provisions of the life cycle theory, subject to their meaningful development, it is possible to form such a model of the evolutionary transformation of the healthcare financing mechanism, which ensures a stable state of the socio-economic system of the region. Requirements for the healthcare financing model, which ensure the necessary state of economic security of the regional socio-economic system, are formulated.

Features of foreign models of healthcare financing

Features of foreign models of healthcare financing

Robotic surgery in Nigeria: an uncertain possibility

Since its introduction about 2 decades ago, surgical robots are becoming increasingly used in many surgical operations. The emerging technology has increased the efficiency, reliability and precision of surgical procedures. It has minimized overall post-operative complications and led to faster patient recovery. Although there are some limitations to robotic surgery, its many advantages have generated great excitement within the surgical community. Thus, there is an exponential growth in the use of the surgical robot across numerous surgical specialties and in many developed nations of the world. In Africa, the robotic surgical system has only been adopted in South Africa and Egypt for limited surgical cases. However, there has been no documented use in Nigeria. The implementation of robotic surgery in Nigeria is been hampered by low budget allocation to health, a regressive health care financing model, epileptic power supply and most of all, poor leadership make the implementation of robotic surgery in Nigeria challenging. The cost of acquiring and maintaining the surgical robot will gradually become cheaper as more robotic surgical manufacturers enter the marketplace, thereby making it more affordable and accessible in low- and middle-income countries. Effective leadership and critical investment in health care systems and human capital, will increase the possibility of implementing a robotic surgical program in the future.

Healthcare Financing Sources in Central Europe

Purpose: The objective of the paper is to review historical developments and the current setup of healthcare financing models in Central Europe. Methodology: A systematic narrative approach has been taken with the research emphasis on a critical literature review and analyses of healthcare spending statistical data. Findings: A comparison between different models currently in place seems to suggest the existence of patterns leading to improved quality of the healthcare service proposition that is critically impacted by a financing model. Implications: The findings have practical implications since different results have been achieved in countries choosing different models but starting from practically the same point. That realisation should serve as a foundation for further work on this subject, potentially leading to adjustments to financing models chosen by some countries. Value: The paper offers a comparative analysis of the healthcare system financing evolution in four Central European Countries and an overview of their current state.

Health financing reform in the primary health care in Montenegro

Abstract Background Primary health care financing reform should be undertaken with aim to support universal health coverage, make the health care accessible and to provide a financial risk sharing in a way that prevents suffering of financial hardship. Objectives To describe challenges, development and introduction of primary health care financing reform in Montenegro. The specific objective was to assess the effectiveness of the implementation of the capitation formula. Methods This retrospective study has been undertaken to describe implementation of a capitation formula in Montenegro. Results Eight years after the implementation (2017 data) indicate that some monitoring indicators reflect output increase in the primary health care, such as number of prevention services provided to the patients (adult population of age 18 years and more). However, other indicators. e.g., number of referrals to other levels of healthcare is rising, indicating that primary care might not be meeting the adequate level of health care needs of the population. Conclusions Montenegrin experience shows that financing reform in short term resulted in establishment of a system based on output models of health care financing and increased capacities for performing main financing functions. Key messages Introduction of a capitation formula represented a fundamental shift in the way primary health care was financed in Montenegro. Further research needs to be done on how primary care responds to the needs of the population.

PROCEDURE AND PROBLEMS OF FINANCING PROVISION OF HEALTH CARE TO THE IMPRISONED PERSONS

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.

ОСОБЛИВОСТІ ФУНКЦІОНУВАННЯ СВІТОВИХ МОДЕЛЕЙ ФІНАНСУВАННЯ ОХОРОНИ ЗДОРОВ’Я

The main goal of any country's health care system is to improve the health of the population and life expectancy. Studying the experience of developed countries allows to make reasonable proposals for improving the existing model of healthcare in Ukraine.Research into the practical aspects of the functioning of health care, its financing and development is a priority.The issues of adapting the experience of developed countries to the model of financing health care in Ukraine, taking into account the socio-economic state of its development, remain unsolved in full.The purpose of the article is to analyze the existing global models of health care financing and leading countries, as well as to identify areas for adapting foreign experience to the Ukrainian model of health care financing.There were analyzed the three major models of health care in the world. The advantages and disadvantages of each of them are identified, as well as the areas of implementation suitable for Ukraine. The experience of the leading countries in eachof the studied models -Great Britain, Germany, USA is considered.The study allowed to obtain systematic information on global models of health care and identify areas for improvement for Ukraine (development of state insurance programs, introduction of compulsory health insurance, increasing the level of innovation).

Value based healthcare - principles and recommendations for organizational solutions in Poland.

The aim of this paper is is to present the assumptions of the Value Based Healthcare concept, the related benefits and examples of countries in which the concept is implemented. The article also proposes solutions based on the VBHC model that could be implemented in the Polish healthcare system. A literature search was conducted using the PubMed via Ovid database using the following keywords: Gray literature items were also analyzed using the Google Scholar tool and other documents, eg of the European Commission. Then the work was divided into the following thematic areas: definitions and principles of VBHC, benefits and challenges related to the implementation of the model, VBHC in Europe, recommendations for solutions in Poland based on VBHC. Value Based Healthcare (VBHC) is a healthcare financing model developed by M. Porter and E. Teisberg. It is based on the assumptions of financing healthcare providers based on treatment outcomes, that is, values. This concept was created in connection with the constantly growing costs in the American healthcare system, which, however, did not translate into health indicators in the population. The aim of VBHC is to minimize the cost of the system while achieving the best result for the patient. In this model of healthcare organization, it is assumed that those healthcare providers who provide the best quality care should be best financed, thus contributing to cure or significantly improving the quality of life of patients. Value Based Healthcare is the recommended method of financing due to the optimization of healthcare expenses while maintaining the appropriate quality of services provided to patients. Currently, many countries in Europe and around the world have started implementing this system solution. However, the transition from a service charge to value for money model is a complex process. In the authors' opinion, the longterm benefits of such a financing model bring a significant improvement in the quality of services and patient satisfaction.