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1.
Stomatologiia (Mosk) ; 100(1): 67-72, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33528959

RESUMEN

THE AIM OF THE STUDY: Was to analyze financial feasibility of obligatory medical insurance programs in dentistry based on the cost of relative unit of labor intensity. MATERIAL AND METHODS: The study is based on statistical analysis of service types and costs dynamics in dental obligatory medical insurance programs in Russia in 2013-2018. RESULTS: The study identified trends in financing health care, government guarantee programs and financial costs per 1 unit of labor intensity, which should be taken into account when making a medical and economic feasibility study of basic and territorial government guarantee programs to provide citizens of the Russian Federation with free medical care and planning the dental section of the compulsory medical insurance program. CONCLUSION: The financial possibilities of implementing the compulsory medical insurance program in the field of dentistry in the Russian Federation are limited by reducing the cost of dental services from the total amount of healthcare financing, not proportional to the increase in inflation and the level of expenses for the compulsory medical insurance program, aggravation of the pathology of patients and untimely treatment for dental services. The provision of planned dental services and preventive measures will reduce the financial costs of these services.


Asunto(s)
Financiación de la Atención de la Salud , Seguro , Odontología , Humanos , Seguro de Salud , Federación de Rusia
3.
Am J Public Health ; 111(4): 739-742, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33600250

RESUMEN

Objectives. To understand whether and how crowdfunding campaigns are a source of COVID-19-related misinformation.Methods. We searched the GoFundMe crowdfunding platform using 172 terms associated with medical misinformation about COVID-19 prophylaxes and treatments. We screened resulting campaigns for those making statements about the ability of these searched-for or related terms to prevent or treat COVID-19.Results. There were 208 campaigns worldwide that requested $21 475 568, raised $324 305 from 4367 donors, and were shared 24 158 times. The most discussed interventions were dietary supplements and purported immune system boosters (n = 231), followed by other forms of complementary and alternative medicine (n = 24), and unproven medical interventions (n = 15). Most (82.2%) of the campaigns made definitive efficacy claims.Conclusions. Campaigners focused their efforts on dietary supplements and immune system boosters. Campaigns for purported COVID-19 treatments are particularly concerning, but purported prophylaxes could also distract from known effective preventative approaches. GoFundMe should join other online and social media platforms to actively restrict campaigns that spread misinformation about COVID-19 or seek to better inform campaigners about evidence-based prophylaxes and treatments.


Asunto(s)
Comunicación , Colaboración de las Masas/economía , Financiación de la Atención de la Salud , Medios de Comunicación Sociales , Terapias Complementarias , Suplementos Dietéticos , Humanos
4.
Prev Med ; 145: 106421, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33422575

RESUMEN

COVID-19 vaccination efforts are underway offering hope for saving lives and eliminating the pandemic. The most promising vaccines require two injections separated 3-4 weeks apart. To achieve heard immunity, 70-90% of the population or perhaps more must be inoculated. Anticipation of adherence challenges has generated commentaries on strategies to enhance adherence including financial incentives. A notable gap in these commentaries is any discussion of the scientific evidence regarding the efficacy of financial incentives for increasing vaccine adherence. This commentary addresses that gap. There is a body of controlled trials on incentivizing vaccine adherence, mostly to the hepatitis B virus (HBV) vaccine among injection drug users (IDUs). Prevalence of HBV infection is increasing as part of the opioid addiction crisis. The HBV vaccine entails a three-dose regimen (typically 0, 1, and 6 months) which has created adherence challenges among IDUs. Systematic literature reviews document significant benefit of financial incentives. For example, a 2019 meta-analysis (Tressler & Bhandari, 2019) examined 11 controlled trials examining HBV-vaccine adherence strategies, including financial incentives, accelerated dosing schedules, and case-management/enhanced services. Financial incentives were most effective resulting in a 7-fold increase in adherence to the vaccination regimen relative to no financial incentives (OR, 7.01; 95% CI, 2.88-17.06). Additional reviews provide further support for the efficacy of financial incentives for promoting adherence with vaccination (HBV & influenza). Overall, this literature suggests that financial incentives could be helpful in promoting the high levels of adherence to COVID-19 vaccines that experts project will be necessary for herd immunity.


Asunto(s)
/economía , Financiación de la Atención de la Salud , Motivación , Vacunación/economía , Vacunación/psicología , Vacunación/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
7.
Health Res Policy Syst ; 19(1): 4, 2021 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-33435989

RESUMEN

INTRODUCTION: Health financing systems have a key role in achieving universal health coverage (UHC) across the globe. However, little is known about how best to monitor health financing system progress towards UHC, especially in low- and middle-income countries. This is a protocol of a study that will aim to assess health financing system progress towards achieving UHC in Iran. METHODS: An explanatory mixed-method approach will be used in two phases. In the quantitative phase, the performance of the Iranian health financing system will be assessed using a well-established set of indicators to draw on progress over 5-year intervals starting in the year 2000 up to the present. Data will be extracted from the global health expenditure database using a specific form and will be classified in accordance with each indicator. A qualitative phase will then take place considering the Kutzin et al. framework and by using health financing progress matrices. The qualitative phase will consist of two successive stages; first, a descriptive overview on the major health coverage schemes along with key attributes of each scheme. This initial mapping will be the underlying background for the second stage. In the second stage, the matrices comprised of a series of questions and relevant to the core functions of health financing and cross-cutting options will be invested in enhancing the evaluation of the ongoing reforms or policies. In this phase, data will be collected by reviewing national policy documents and in-depth interviews with key informants who will be recruited using purposive sampling. Finally, a policy discussion with key stakeholders will be held in order to review and verify the consistency between the current health financing policy and UHC goals. DISCUSSION: This study will provide a comprehensive image about the current status of the national health financing system progress towards achieving UHC in Iran. Such assessment will give detailed insight about the performance of the current financing system through identifying encountered challenges. Furthermore, some other defects in the design of the financing system are expected to appear. In all likelihood, the results will be fruitful enough to make informed decisions about interventions and policies in relation to UHC. ETHICS AND DISSEMINATION: The study protocol has been approved by the Ethics Committee for Research at Tehran University of Medical Sciences. Informed consent will be obtained from all key informants and the data will be collected and transcribed anonymously in order to maintain utmost confidentiality. The results will be disseminated in peer-reviewed journals and presented in national and international conferences and meetings.


Asunto(s)
Financiación de la Atención de la Salud , Proyectos de Investigación , Cobertura Universal del Seguro de Salud/economía , Programas de Gobierno , Humanos , Irán
10.
Afr J Prim Health Care Fam Med ; 12(1): e1-e9, 2020 Dec 15.
Artículo en Francés | MEDLINE | ID: mdl-33354981

RESUMEN

Reform and Performance of the Provincial Health Inspectorate and the Provincial Division of Health of South Kivu in the Democratic Republic of Congo. BACKGROUND: The intermediate level incorporated both the Provincial Health Inspectorate (IPS) and the Provincial Health Division (DPS) of Health. The new constitution of 2006 gave impetus to decentralisation, which became effective in 2015. The reform introduced at the intermediate level clearly separated the IPS and the DPS. This article assesses the effect of this reform on the performance of IPS and DPS in South Kivu, Democratic Republic of Congo. METHODOLOGY: The study is evaluative before and after and covers the period from 2012 to 2017. It uses mixed methods: three techniques were used to collect data including observation, document review and individual interviews. The analysis of the quantitative data concerned the evolution of the indicators; that of qualitative data was carried out by themes from two theoretical models: the ministerial functional framework and the 'Strengths, Weaknesses, Opportunities and Threats' analysis framework (SWOT analysis). Scores were assigned to each managerial function according to their level of performance for better comparison. RESULTS: After the reform, a decline in the performance score of activities devolved to IPS is noted, mainly due to the low funding of activities. On the other hand, in the DPS, the evolution of the score is favorable, because of the strong support given to the reform at this level by the partners and the government. The alignment of partners to a single contract for funding DPS activities is observed. The weak financing of the health sector by the government remains a weak point, however, and the brain drain a threat to institutional sustainability. The introduction of the single financing contract constitutes an opportunity to improve the performance of the provincial management team. DISCUSSION AND CONCLUSION: The study shows the improvement in the performance of managerial functions of the DPS and the regression to the IPS. The low funding of IPS by the Congolese government could jeopardise the reform.


Asunto(s)
Gobierno , Reforma de la Atención de Salud , Calidad de la Atención de Salud , República Democrática del Congo , Sector de Atención de Salud , Personal de Salud , Financiación de la Atención de la Salud , Humanos , Política
11.
Washington, D.C.; PAHO; 2020-12-11.
en Inglés | PAHO-IRIS | ID: phr-53124

RESUMEN

The essential public health functions (EPHFs) have constituted the core of the agenda for strengthening the health sector in the Region of the Americas since the 1980s. Their conceptual development and measurement in the Region came in response to sectoral reforms that threatened to reduce the role of the State and public health, particularly the stewardship function of the health authorities. In that context, in 2000, the Member States of the Pan American Health Organization (PAHO) proposed to promote a conceptual and methodological framework for public health and its essential functions, giving rise to the regional initiative called "public health in the Americas". As part of this initiative, the essential functions of public health authorities were identified, their relevance was discussed, and a broad regional consensus was reached, as explained below. More than 15 years have passed. In response to current needs, this document reviews and updates the EPHF conceptual framework for the Region of the Americas. This new version is based on the experiences and lessons learned from the implementation and regional measurement of the EPHFs, new and persistent challenges for the health of the population and its social determinants, and new institutional, economic, social, and political conditions which affect the Region of the Americas. The document is structured into five sections. The first presents the key experiences and challenges that justify a renewal of the EPHFs. The second section updates the groundwork for the exercise of public health and provides a framework to inform the exercise of the new essential functions. The third section proposes a new integrated approach for implementing the EPHFs. The fourth section presents a new list of 11 EPHFs related to each stage of this integrated approach. Finally, in the last section, considerations are put forth to guide EPHF implementation as a means of strengthening the health sector.


Asunto(s)
Sistemas de Salud , Zoonosis , Enfermedades Desatendidas , Acceso Universal a los Servicios de Salud , Universalización de la Salud , Rectoría y Gobernanza del Sector de Salud , Financiación de la Atención de la Salud , Financiación de los Sistemas de Salud , Política de Salud
12.
BMJ ; 371: m4750, 2020 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-33323376

RESUMEN

OBJECTIVE: To analyze the premarket purchase commitments for coronavirus disease 2019 (covid-19) vaccines from leading manufacturers to recipient countries. DESIGN: Cross sectional analysis. DATA SOURCES: World Health Organization's draft landscape of covid-19 candidate vaccines, along with company disclosures to the US Securities and Exchange Commission, company and foundation press releases, government press releases, and media reports. ELIGIBILITY CRITERIA AND DATA ANALYSIS: Premarket purchase commitments for covid-19 vaccines, publicly announced by 15 November 2020. MAIN OUTCOME MEASURES: Premarket purchase commitments for covid-19 vaccine candidates and price per course, vaccine platform, and stage of research and development, as well as procurement agent and recipient country. RESULTS: As of 15 November 2020, several countries have made premarket purchase commitments totaling 7.48 billion doses, or 3.76 billion courses, of covid-19 vaccines from 13 vaccine manufacturers. Just over half (51%) of these doses will go to high income countries, which represent 14% of the world's population. The US has reserved 800 million doses but accounts for a fifth of all covid-19 cases globally (11.02 million cases), whereas Japan, Australia, and Canada have collectively reserved more than one billion doses but do not account for even 1% of current global covid-19 cases globally (0.45 million cases). If these vaccine candidates were all successfully scaled, the total projected manufacturing capacity would be 5.96 billion courses by the end of 2021. Up to 40% (or 2.34 billion) of vaccine courses from these manufacturers might potentially remain for low and middle income countries-less if high income countries exercise scale-up options and more if high income countries share what they have procured. Prices for these vaccines vary by more than 10-fold, from $6.00 (£4.50; €4.90) per course to as high as $74 per course. With broad country participation apart from the US and Russia, the COVAX Facility-the vaccines pillar of the World Health Organization's Access to COVID-19 Tools (ACT) Accelerator-has secured at least 500 million doses, or 250 million courses, and financing for half of the targeted two billion doses by the end of 2021 in efforts to support globally coordinated access to covid-19 vaccines. CONCLUSIONS: This study provides an overview of how high income countries have secured future supplies of covid-19 vaccines but that access for the rest of the world is uncertain. Governments and manufacturers might provide much needed assurances for equitable allocation of covid-19 vaccines through greater transparency and accountability over these arrangements.


Asunto(s)
/economía , Salud Global/economía , Accesibilidad a los Servicios de Salud/economía , Financiación de la Atención de la Salud , /inmunología , Estudios Transversales , Países Desarrollados/economía , Países en Desarrollo/economía , Accesibilidad a los Servicios de Salud/organización & administración , Humanos
13.
Rev Saude Publica ; 54: 127, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33331523

RESUMEN

OBJECTIVE: To examine the financing of the Unified Health System (SUS) from 2010 to 2019 and analyze the recent trends in the allocation of federal resources to large areas of operation of the system, as well as the possibility of achieving the Sustainable Development Goal (SDG) 3 of the 2030 Agenda. METHODS: Data from the budgetary and financial execution of the federation entities were obtained. Transfers from the Brazilian Ministry of Health (MH) to the municipal and state departments and their direct applications were identified according to large final areas of SUS and middle areas. Basic descriptive statistics, graphs and tables were used to analyze the execution of expenses by these areas. RESULTS: Public spending per capita on health increased between 2010 and 2018. However, compared to 2014, it reduced 3% in 2018. There was a displacement of the allocation of federal resources to the detriment of transfers to the states (-21%). There are also losses of health surveillance in favor of primary care and pharmaceuticals. In the case of primary care, the increase in spending was tied to changes in policy and the expansion of resources allocated by parliamentary amendments. In the case of pharmaceuticals, the increase was due to the incorporation of new drugs, including vaccines, judicialization, increased spending on blood products and centralization, in the MH, of the purchase of items of high budgetary impact. CONCLUSION: If there is no change in the current SUS financing framework, something unlikely under Constitutional Amendment No. 95, associated with the redefinition of health policy priorities, the risk of non-compliance with the SDG 3 of the Agenda 2030 is very high.


Asunto(s)
Financiación Gubernamental , Gastos en Salud , Financiación de la Atención de la Salud , Programas Nacionales de Salud , Brasil , Objetivos , Humanos
14.
Health Syst Reform ; 6(1): e1847991, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33337274

RESUMEN

Pacific Island countries (PIC) have emerged as among the most at-risk globally from the collateral economic damage resulting from the COVID-19 pandemic, despite being largely spared its direct health effects so far. Current projections indicate that all PIC will experience an economic contraction in 2020, ranging from -1.0% in Tuvalu to -21.7% in Fiji, worse than most countries globally on average. Given that more than 80% of financing for health in the Pacific comes from domestic and external public sources, the net impact of the economic contraction on resources for health will depend on whether overall public spending can offset the decline in economic activity and how health will be prioritized in government budgets relative to other sectors. Without active reprioritization, most countries could see a slowdown or even decline in per capita levels of public spending for health in the region, risking gains made in advancing universal health coverage in recent years. If health ministries do not act quickly and in consort with other ministries (particularly ministries of finance), including by taking active steps to improve the efficient use of existing resources and other measures to mitigate the economic effects of the crisis on resources for health, it is likely that current economic circumstances will result in unplanned changes. These changes may not deliver the health outcomes that the health ministries would select themselves and may result in a reversal of hard-fought health gains.


Asunto(s)
/economía , Recesión Económica , Financiación de la Atención de la Salud , Humanos , Islas del Pacífico/epidemiología
17.
Official Document;360ODD360.
Monografía en Inglés | PAHO-IRIS | ID: phr-52810

RESUMEN

During 2019, PAHO exercised its leadership and role as a catalyst to improve the health and well‐being of the peoples of the Americas, in collaboration with Member States and partners. The Organization continued to provide direct technical cooperation with an integrated and multisectoral approach, mobilize resources, strengthen partnerships and networks, build capacity, generate and provide evidence, and serve as an advocate for achieving the targets set in the PAHO Strategic Plan 2014‐2019 during its final year of implementation. Important progress was made toward fulfilling the commitments in the Sustainable Health Agenda for the Americas 2018‐2030 and the 2030 Agenda for Sustainable Development.


Asunto(s)
Financiación de la Atención de la Salud , Administración en Salud , Administración Financiera , Capacidad de Liderazgo y Gobernanza , Planificación Estratégica , Cooperación Técnica , Organización Panamericana de la Salud , Organización y Administración
18.
Artículo en Español | PAHO-IRIS | ID: phr-52781

RESUMEN

[RESUMEN]. Los países de América Latina y el Caribe necesitan aumentar sus recursos públicos en salud para ampliar el acceso equitativo y eficiente a la salud. El aumento debe financiar un modelo específico que ha mostrado evidencia de eficacia, como el de redes integradas de servicios de salud (RISS) basadas en atención primaria de salud. La literatura global no ha prestado suficiente atención al financiamiento a las RISS; más bien se ha focalizado en establecimientos y agentes aislados, así como en mecanismos específicos. Sin embargo, en la Región de las Américas su desarrollo es una necesidad desde hace años. Una RISS es un conjunto de organizaciones de salud que ofrece intervenciones y servicios de salud coordinados a una población bajo su cargo y asume la responsabilidad de salud y económica en el logro de mejores resultados de salud. Un sistema de pago a una RISS debe ir dirigido a promover la integralidad de la atención y a fomentar un enfoque centrado en el ciclo de vida de las personas, la articulación y la coordinación de servicios. El presupuesto poblacional ajustado por riesgos se muestra como un mecanismo posible y potente para apoyar el logro de los objetivos. Su desarrollo requiere reconocer que la forma de financiamiento no responderá por sí sola a los desafíos y que se necesita, a la vez, de la planificación y de la gestión sanitarias. Se requiere abordar los desafíos técnicos, políticos e institucionales para tener éxito en este esfuerzo, que a su vez debe estar inserto en el proceso global de transformación de los sistemas de salud hacia la salud universal.


[ABSTRACT]. The countries of Latin America and the Caribbean need to increase their public resources in health to expand equitable and efficient access to health. The increase should finance a specific model with proven effectiveness, such as integrated health service networks (IHSN) based on primary health care. The global literature has not paid sufficient attention to financing IHSN; rather, it has focused on isolated facilities and agents, as well as on specific mechanisms. However, in the Region of the Americas, their development has been a necessity for years. An IHSN is a group of health organizations that offers coordinated health interventions and services to a population under their charge and assumes health and economic responsibility for achieving better health outcomes. A system of payment to an IHSN should be aimed at promoting the integrality of care and encouraging a focus on the life cycle of individuals, the articulation and the coordination of services. The risk-adjusted population budget is a possible and powerful mechanism to support the achievement of the objectives. Its development requires the recognition that the type of financing alone will not respond to the challenges and that there is a need for both health planning and health management. The technical, political and institutional challenges need to be addressed to succeed in this effort, which in turn must be embedded in the overall process of transforming health systems towards universal health.


Asunto(s)
Asignación de Recursos para la Atención de Salud , Capitación , Sistemas de Salud , Financiación de la Atención de la Salud , Américas , Asignación de Recursos para la Atención de Salud , Capitación , Sistemas de Salud , Financiación de la Atención de la Salud , Américas
19.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47802

RESUMEN

Traz informações relevantes acerca do financiamento e gastos nas ações e serviços públicos de Saúde no Brasil.


Asunto(s)
Economía de la Salud , Financiación de la Atención de la Salud , Gastos en Salud , Servicios Públicos de Salud
20.
Healthc Q ; 23(2): 18-20, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32762815

RESUMEN

A scientific paper published in the BMJ Open made international headlines by claiming that austerity policies led to 120,000 deaths in the UK (Watkins et al. 2017).


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Financiación de la Atención de la Salud , Pandemias , Neumonía Viral , Canadá , Política de Salud/economía , Accesibilidad a los Servicios de Salud/economía , Humanos , Pobreza , Salud Pública/economía
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