A descriptive framework for country-level analysis of health care financing arrangements
A descriptive framework for country-level analysis of health care financing arrangements
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DOI：
10.1016/s0168-8510(00)00149-4
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发表时间：
2001-06-01
期刊：
影响因子：
3.3
通讯作者：
Kutzin, J
中科院分区：
文献类型：
--
作者：
Kutzin, J
卫生筹资政策的特点是政策工具和政策目标之间的混淆。特别是在低收入和中等收入国家。本文试图通过提供一个概念性的框架来解决这一问题，该框架是由加强卫生保健系统的“保险功能”(获得必要的护理而不会造成经济贫困)这一规范性目标驱动的。该框架被提议作为对关键功能进行描述性分析的工具。政策。以及现有医疗保健系统内的相互作用。并同样作为一种工具来协助确定；对政策选择进行初步评估。其目的是帮助澄清可用来尽可能有效地加强人口保险职能的政策杠杆。鉴于一个国家现有体制和组织安排的“起点”。利用这一框架对保健筹资系统进行分析，突出了各种政策之间的相互作用，以及需要一套协调一致的改革方案。而不是把重点放在特定的组织形式的“健康保险”上。医疗保健系统各主要职能(税收征收)的内容。资金的汇集。购买服务。提供服务)和组织实施每一项服务的市场结构被认为特别重要。有关福利套餐和使用费的政策也是如此。(C)2001爱思唯尔爱尔兰科学有限公司。保留所有权利。
Health financing policies are marked by confusion between policy tools and policy objectives. especially in low and middle income countries. This paper attempts to address this problem by providing a conceptual framework that is driven by the normative objective of enhancing the 'insurance function' (access to needed care without financial impoverishment) of health care systems. The Framework is proposed as a tool for descriptive analysis of the key functions. policies. and interactions within an existing health care system. and equally as a tool to assist the identification;Ind preliminary assessment of policy options. The aim is to help to clarify the policy levers that are available to enhance the insurance function for the population as efficiently as possible. given the 'starting point' of a country's existing institutional and organizational arrangements. Analysis of health care financing systems using this framework highlights the interactions of various policies and the need for a coherent package of coordinated reforms. rather than a focus on particular organizational forms of 'health insurance'. The content of each main health care system function (revenue collection. pooling of funds. purchasing of services. provision of services) and the market structure with which the implementation of each is organized are found to be particularly important. as are policies with respect to the benefit package and user fees. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.