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1.
Int J Equity Health ; 19(1): 61, 2020 05 06.
Artículo en Inglés | MEDLINE | ID: mdl-32375787

RESUMEN

On February 19th 2020, the Iranian Ministry of Health and Medical Education (MoHME) has announced the first 2 cases of SARS-CoV-2, a novel emerging coronavirus which causes an infection termed as COVID-19, in Qom city. As such, the Iranian government, through the establishment of the "National Headquarters for the management and control of the novel Coronavirus", has started implementing policies and programs for the prevention and control of the virus. These measures include schools and universities closure, reduced working hours, and increased production and delivery of equipment such as masks, gloves and hygienic materials for sterile environments. The government has also made efforts to divulge high-quality information concerning the COVID-19 and to provide laboratories and hospitals with diagnostic kits and adequate resources to treat patients. However, despite such efforts, the number of cases and deaths has progressively increased with rising trends in total confirmed cases and deaths, as well as in new daily cases and deaths associated with the COVID-19. Iran is a developing country and its economic infrastructure has been hit hardly by embargo and sanctions. While developed countries have allocated appropriate funding and are responding adequately to the COVID-19 pandemics, Iran has experienced a serious surge of cases and deaths and should strive to provide additional resources to the health system to make healthcare services more accessible and to increase the fairness of that access. All relevant actors and stakeholders should work together to fight this disease.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Financiación de la Atención de la Salud , Pandemias/economía , Neumonía Viral/prevención & control , Betacoronavirus , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/epidemiología , Humanos , Irán/epidemiología , Pandemias/prevención & control , Neumonía Viral/economía , Neumonía Viral/epidemiología
3.
J Glob Health ; 10(1): 010803, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32257167

RESUMEN

Background: China's health financing system has changed from the government-led mode under the planned economy to the diversified mode under the market economy. Equity in health financing has been a national health priority. This study aimed to predict changes in total health expenditure (THE), government health expenditure (GHE), social health expenditure (SHE) and out-of-pocket health expenditure (OOP) in China from 2018 to 2022, and to provide a theoretical basis for health policy adjustment. Methods: Based on health expenditure date of time series from 1978-2017, R3.5.1 software was used to construct the Autoregressive Integrated Moving Average (ARIMA) model. Results: The model of THE, GHE, SHE and OOP are ARIMA (3.3.0), ARIMA (1.3.1), ARIMA (2.4.0), ARIMA (2.2.2). According to the simulation results, in 2022, China's THE is expected to reach 8473.00 billion Yuan, and the constituent ratios in GHE, SHE and OOP will be 25.49%, 51.25% and 23.26%, respectively. The proportion of THE to GDP will continuously increase from 2018-2022 at a reasonable pace, while THE itself will increase rapidly. Conclusions: China should take effective measures to control the excessive growth of THE, keep decreasing the OOP percentage, and improve the efficiency and fairness of the use of health funds.


Asunto(s)
Gastos en Salud , Financiación de la Atención de la Salud , China , Reforma de la Atención de Salud , Humanos , Modelos Estadísticos , Valor Predictivo de las Pruebas
5.
Acta Med Port ; 33(4): 269-274, 2020 Apr 01.
Artículo en Portugués | MEDLINE | ID: mdl-32238241

RESUMEN

INTRODUCTION: Asthma affects more than 339 million people worldwide. In the Community of Portuguese Speaking Countries, in 2016, its prevalence ranged from 9.5% (Portugal) to 3.91% (Brazil). Chronic disease management programs aim to improve the health status of patients with chronic disease and reduce associated costs. The objective of this study is to identify models of asthma asthma 'management and control' that are that are implemented in the Community of Portuguese Speaking Countries (CPLP), and analyse them through the integrated disease management model. MATERIAL AND METHODS: A rapid review of the PubMed indexed scientific literature and grey literature on 'management and control of asthma' in the countries of the Community of Portuguese-Speaking Countries was carried out. RESULTS: Portugal, Brazil and Mozambique presented publications on 'management and control of asthma', at different stages of implementation. Clinical management and organization and service delivery are the dimensions of integrated disease management most addressed in publications. DISCUSSION: The implementation of asthma management and control programs is influenced by health systems, care delivery structures, and the surrounding political and social environment. The dimensions of funding and information systems are the most difficult to implement given the degree of economic, social and technological development of most countries under study. CONCLUSION: Only Portugal, Brazil and Mozambique adopted asthma integrated disease management as the main form of asthma management and control. The programs developed by these countries can constitute a model for asthma integrated disease management in the other countries under study.


Asunto(s)
Asma/terapia , Manejo de la Enfermedad , Asma/prevención & control , Brasil , Financiación de la Atención de la Salud , Humanos , Sistemas de Información , Lenguaje , Mozambique , Portugal , Desarrollo de Programa
7.
Medicine (Baltimore) ; 99(9): e19379, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32118784

RESUMEN

To examine the willingness to pay (WTP) for a quality-adjusted life year (QALY) gained among advanced non-small cell lung cancer (NSCLC) patients in Viet Nam and to analyze the factors affecting an individual's WTP.A cross-sectional, contingent valuation study was conducted among 400 NSCLC patients across 6 national hospitals in Viet Nam. Self-reported information was recorded from patients regarding their socio-demographic status, EQ-5D (EuroQol-5 dimensions) utility, EQ-5D vas, and WTP for 1 QALY gained. To explore the factors related to the WTP, Gamma Generalized Linear Model and multiple logistic regression tools were applied to analyze data.The overall mean and median of WTP/QALY among the NSCLC patients were USD $11,301 and USD $8002, respectively. Strong association was recorded between WTP/QALY amount and the patient's education, economic status, comorbidity status, and health utility.Government and policymakers should consider providing financial supports to disadvantaged groups to improve their access to life saving cancer treatment.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/economía , Carcinoma de Pulmón de Células no Pequeñas/psicología , Financiación de la Atención de la Salud , Pacientes Internos/psicología , Años de Vida Ajustados por Calidad de Vida , Adolescente , Adulto , Anciano , Carcinoma de Pulmón de Células no Pequeñas/terapia , Estudios Transversales , Femenino , Humanos , Pacientes Internos/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Vietnam
8.
Washington, D.C.; OPS; 2020-02-26.
en Español | PAHO-IRIS | ID: phr-51888

RESUMEN

El informe Seguridad social en Centroamérica y República Dominicana: situación actual y desafíos ofrece una descripción general de los principales regímenes vigentes en los sistemas y las instituciones de seguridad social de Centroamérica y el Caribe, realiza un análisis comparativo de esos regímenes, y presenta los desafíos regionales en materia de seguridad social, junto con las metas y los indicadores conexos para el decenio 2018-2028. Más allá de la diversidad en cuanto a la madurez y el desarrollo de los arreglos institucionales de seguridad social de la región, es posible distinguir una serie de desafíos comunes que pueden abordarse utilizando como marco de referencia la Estrategia para el acceso universal a la salud y la cobertura universal de salud de la Organización Panamericana de la Salud del 2014. Algunos de ellos se relacionan con temas estructurales que requieren importantes transformaciones en términos de rectoría y gobernanza —como la segmentación de los sistemas y la fragmentación de los servicios, la ampliación del número de contribuyentes y un financiamiento adecuado a las necesidades de la población— y otros con la prestación de los servicios de salud —un aspecto que requiere la transición a una atención integral y el fomento de la articulación de los distintos niveles de atención a través de redes integradas—. Para la elaboración de este documento se han consultado documentos oficiales de las instituciones de seguridad social de los países miembros del CISSCAD, la legislación vigente en los países y normas de cada institución, y se ha recurrido a bases de datos y publicaciones de organismos internacionales. Este informe está dirigido a profesionales, académicos y expertos del sector de la salud y la protección social interesados en la evolución de los sistemas de seguridad social en la Región de las Américas. Brinda información y análisis de datos que representan aportes técnicos útiles para debatir y formular propuestas de mejoras en los institutos de seguridad social de toda la Región.


Asunto(s)
Financiación de los Sistemas de Salud , Financiación de la Atención de la Salud , Políticas, Planificación y Administración en Salud , Planes y Programas de Salud , Seguridad Social , Equidad en el Acceso a los Servicios de Salud , Cobertura Universal de Salud , Belice , Costa Rica , El Salvador , Guatemala , Honduras , Nicaragua , Panamá , República Dominicana
9.
PLoS Med ; 17(1): e1003013, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31940342

RESUMEN

BACKGROUND: The United States is the only high-income nation without universal, government-funded or -mandated health insurance employing a unified payment system. The US multi-payer system leaves residents uninsured or underinsured, despite overall healthcare costs far above other nations. Single-payer (often referred to as Medicare for All), a proposed policy solution since 1990, is receiving renewed press attention and popular support. Our review seeks to assess the projected cost impact of a single-payer approach. METHODS AND FINDINGS: We conducted our literature search between June 1 and December 31, 2018, without start date restriction for included studies. We surveyed an expert panel and searched PubMed, Google, Google Scholar, and preexisting lists for formal economic studies of the projected costs of single-payer plans for the US or for individual states. Reviewer pairs extracted data on methods and findings using a template. We quantified changes in total costs standardized to percentage of contemporaneous healthcare spending. Additionally, we quantified cost changes by subtype, such as costs due to increased healthcare utilization and savings due to simplified payment administration, lower drug costs, and other factors. We further examined how modeling assumptions affected results. Our search yielded economic analyses of the cost of 22 single-payer plans over the past 30 years. Exclusions were due to inadequate technical data or assuming a substantial ongoing role for private insurers. We found that 19 (86%) of the analyses predicted net savings (median net result was a savings of 3.46% of total costs) in the first year of program operation and 20 (91%) predicted savings over several years; anticipated growth rates would result in long-term net savings for all plans. The largest source of savings was simplified payment administration (median 8.8%), and the best predictors of net savings were the magnitude of utilization increase, and savings on administration and drug costs (R2 of 0.035, 0.43, and 0.62, respectively). Only drug cost savings remained significant in multivariate analysis. Included studies were heterogeneous in methods, which precluded us from conducting a formal meta-analysis. CONCLUSIONS: In this systematic review, we found a high degree of analytic consensus for the fiscal feasibility of a single-payer approach in the US. Actual costs will depend on plan features and implementation. Future research should refine estimates of the effects of coverage expansion on utilization, evaluate provider administrative costs in varied existing single-payer systems, analyze implementation options, and evaluate US-based single-payer programs, as available.


Asunto(s)
Costos de la Atención en Salud/tendencias , Financiación de la Atención de la Salud , Sistema de Pago Simple/economía , Sistema de Pago Simple/tendencias , Economía/tendencias , Humanos , Estados Unidos
10.
PLoS One ; 15(1): e0226376, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31929554

RESUMEN

BACKGROUND: From January 2015 to December 2016, the health authorities in Burundi piloted the inclusion of child nutrition services into the pre-existing performance-based financing free health care policy (PBF-FHC). An impact evaluation, focused on health centres, found positive effects both in terms of volume of services and quality of care. To some extent, this result is puzzling given the harshness of the contextual constraints related to the fragile setting. METHODS: With a multi-methods approach, we explored how contextual and implementation constraints interacted with the pre-identified tracks of effect transmission embodied in the intervention. For our analysis, we used a hypothetical Theory of Change (ToC) that mapped a set of seven tracks through which the intervention might develop positive effects for children suffering from malnutrition. We built our analysis on (1) findings from the facility surveys and (2) extra qualitative data (logbooks, interviews and operational document reviews). FINDINGS: Our results suggest that six constraints have weighted upon the intervention: (1) initial low skills of health workers; (2) unavailability of resources (including nutritional dietary inputs and equipment); (3) payment delays; (4) suboptimal information; (5) restrictions on autonomy; and (6) low intensity of supervision. Together, they have affected the intensity of the intervention, especially during its first year. From our analysis of the ToC, we noted that the positive effects largely occurred as a result of the incentive and information tracks. Qualitative data suggests that health centres have circumvented the many constraints by relying on a community-based recruitment strategy and a better management of inputs at the level of the facility and the patient himself. CONCLUSION: Frontline actors have agency: when incentives are right, they take the initiative and find solutions. However, they cannot perform miracles: Burundi needs a holistic societal strategy to resolve the structural problem of child malnutrition. TRIAL REGISTRATION: Clinical Trials.gov Identifier: NCT02721160; March 2016 (retrospectively registered).


Asunto(s)
Trastornos de la Nutrición del Niño/patología , Financiación de la Atención de la Salud , Burundi , Niño , Trastornos de la Nutrición del Niño/economía , Instituciones de Salud , Personal de Salud/psicología , Política de Salud , Humanos , Entrevistas como Asunto , Reembolso de Incentivo , Encuestas y Cuestionarios
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