"Diagnosing" Saudi health reforms: is NHIS the right "prescription"?
"Diagnosing" Saudi health reforms: is NHIS the right "prescription"?
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DOI：
10.1002/hpm.2148
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发表时间：
2013-10-01
影响因子：
2.7
通讯作者：
Abdullah, Muhammad Tanweer
中科院分区：
文献类型：
--
作者：
Al-Sharqi, Omar Zayan;Abdullah, Muhammad Tanweer
本文概述了沙特阿拉伯王国(KSA)的卫生背景。它回顾了从1925年到当代新健康保险制度(NHIS)在KSA的卫生系统发展。它还考虑到新出现的挑战，审查了国家健康保险制度的一致性。本文确定了语境一致性的决定因素和范围。首先，它表明需要发展一个本土化的、综合的和全面的保险体系。其次，报告强调了农村和偏远地区在提供服务方面的机会和公平差距，并提出了如何将这些差距纳入保险范围的建议。第三，报告建议如何协调公共和私营部门的投入--私营医疗保健行业的服务质量应受到国家和国际标准的监管，其范围主要由公开市场动态和公共部门福利模式确定，以确保所有人都能获得基本医疗服务。第四，它指出需要实施以证据为基础的公共卫生政策，并弥合政策设计和个人生活方式方面的固有差距。第五，它指出有必要为医疗保险建立一个可行的基础设施。由于KSA健康情景中的社会研究和批判性审查很少，本文提供了对NHIS实施的主流挑战的见解，并确定了需要注意的固有弱点。它为卫生政策制定者、经济学家、规划者、医疗保健服务经理，甚至保险企业提供指导，并为未来类似研究指明了关键方向。版权所有(C)2012 John Wiley&Sons，Ltd.
This paper outlines the health context of the Kingdom of Saudi Arabia (KSA). It reviews health systems development in the KSA from 1925 through to contemporary New Health Insurance System (NHIS). It also examines the consistency of NHIS in view of the emerging challenges. This paper identifies the determinants and scope of contextual consistency. First, it indicates the need to evolve an indigenous, integrated, and comprehensive insurance system. Second, it highlights the access and equity gaps in service delivery across the rural and remote regions and suggests how to bring these under insurance coverage. Third, it suggests how inputs from both the public and private sectors should be harmonized - the quality of services in the private healthcare industry to be regulated by the state and international standards, its scope to be determined primarily by open-market dynamics and the public sector welfare-model to ensure access of all to essential health services. Fourth, it states the need to implement an evidence-based public health policy and bridge inherent gaps in policy design and personal-level lifestyles. Fifth, it points out the need to produce a viable infrastructure for health insurance. Because social research and critical reviews in the KSA health scenario are rare, this paper offers insights into the mainstream challenges of NHIS implementation and identifies the inherent weaknesses that need attention. It guides health policy makers, economists, planners, healthcare service managers, and even the insurance businesses, and points to key directions for similar research in future. Copyright (c) 2012 John Wiley & Sons, Ltd.