Improving access to hospital care for the poor: comparative analysis of four health equity funds in Cambodia.
Improving access to hospital care for the poor: comparative analysis of four health equity funds in Cambodia.
复制标题
改善穷人获得医院护理的机会：柬埔寨四个健康公平基金的比较分析。
DOI：
10.1093/heapol/czm015
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发表时间：
2007
影响因子：
3.2
通讯作者：
W. Van Damme
中科院分区：
文献类型：
--
作者：
Mathieu Noirhomme;B. Meessen;F. Griffiths;P. Ir;Bart Jacobs;Rasoka Thor;B. Criel;W. Van Damme
大量证据表明，卫生部门的使用费造成了排斥。保健公平基金试图通过代表最贫穷者向提供者付款，改善他们获得保健服务的机会。本文回顾了柬埔寨的四个以医院为基础的卫生公平基金，并为未来的运作提供了借鉴。它调查了"谁应该做什么和如何做"的实际问题。它提出，在一个比较的框架，在目标，所涉及的行为者，设计方面和功能模式之间的健康公平基金的异同。本次审查的结果沿着识别线，住院率和相对成本。这四项计划对最贫穷病人利用医院服务的数量产生了积极影响。目前，它们占医院总使用量的7%至52%。同期，付费病人利用医院的情况保持不变。比较审查表明，可以采取一系列的业务安排，以实现健康权益基金的目标。我们的研究确定了基本的设计方面，并为其他人留下了不同的选择。
There is a large body of evidence that user fees in the health sector create exclusion. Health equity funds attempt to improve access to health care services for the poorest by paying the provider on their behalf. This paper reviews four hospital-based health equity funds in Cambodia and draws lessons for future operations. It investigates the practical questions of 'who should do what and how'. It presents, in a comparative framework, similarities and differences in objectives, the actors involved, design aspects and functional modalities between the health equity funds. The results of this review are presented along the lines of identification, hospitalization rates and relative costs. The four schemes had a positive impact on the volume of utilization of hospital services by the poorest patients. They now account for 7 to 52% of total hospital use. The utilization of hospitals by paying patients has remained constant in the same period. The comparative review shows that a range of operational arrangements may be adopted to achieve the health equity fund objectives. Our study identifies essential design aspects, and leaves different options open for others.