The role of community-based health insurance within the health care financing system: a framework for analysis
The role of community-based health insurance within the health care financing system: a framework for analysis
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DOI：
10.1093/heapol/czh018
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发表时间：
2004-05-01
影响因子：
3.2
通讯作者：
Bennett, S
中科院分区：
文献类型：
--
作者：
Bennett, S
有越来越多的倡导社区为基础的健康保险（CBHI）计划作为一个更广泛的解决方案的一部分，在低收入国家的医疗保健融资问题，但迄今为止，有非常有限的了解如何CBHI计划与其他要素的医疗保健融资系统。本文旨在为理解这种相互作用提出一个初步的概念框架，并强调了这种框架提出的研究问题。一个基本的概念图CBHI计划的开发，并扩展到这个地图，包括（1）对计划的非成员的影响，（2）政府补贴的供应商，（3）政府补贴的计划，（4）在特定的情况下，存在多个风险汇集计划提出的问题。更广泛的方法来分析/评估CBHI计划的效用说明通过检查两个政策问题，即（1）协调CBHI风险池和政府风险池，（2）公平的影响CBHI计划和政府补贴的作用，这些计划。它的结论是，有一个强烈的需要进行实证工作，以探讨如何CBHI计划和更广泛的医疗保健融资系统的互动，即使个别计划实现自己的目标（在公平，效率等方面），这并不一定意味着这些目标将在系统一级实现。
There is increasing advocacy for community-based health insurance (CBHI) schemes as part of a broader solution to health care financing problems in low-income countries, but to date there is very limited understanding of how CBHI schemes interact with other elements of a health care financing system. This paper aims to set out a preliminary conceptual framework for understanding such interactions, and highlights the kind of research questions raised by such a framework. A basic conceptual map of a CBHI scheme is developed, and extensions added to this map that incorporate (1) effects upon non-members of schemes, (2) government subsidies to providers, (3) government subsidies to schemes, and (4) issues raised by the existence of multiple risk-pooling schemes in a particular context. The utility of a broader approach to analyzing/assessing CBHI schemes is illustrated through examination of two policy issues, namely (1) coordination of CBHI risk pools and government risk pools, and (2) equity implications of CBHI schemes and the role of government subsidies in such schemes. It is concluded that there is a strong need for empirical work to explore how CBHI schemes and the broader health care financing system interact, and that even if individual schemes achieve their own objectives (in terms of equity, efficiency etc.), this does not necessarily imply that such objectives will be achieved at the system level.