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1.
Artigo em Inglês | MEDLINE | ID: mdl-36674006

RESUMO

Supply-side healthcare financing still dominates healthcare financing in many countries where the government provides line-item budgets for health facilities irrespective of the quantity or quality of services rendered. There is a risk that this approach will reduce the efficiency of services and the value of money for patients. This paper analyzes the situation of public health centers in Cambodia to determine the relevance of supply- and demand-side financing as well as lump sum and performance-based financing. Based on a sample of the provinces of Kampong Thom and Kampot in the year 2019, we determined the income and expenditure of each facility and computed the unit cost with comprehensive step-down costing. Furthermore, the National Quality Enhancement Monitoring Tool (NQEMT) provided us with a quality score for each facility. Finally, we calculated the efficiency as the quotient of quality and cost per service unit as well as correlations between the variables. The results show that the largest share of income was received from supply-side financing, i.e., the government supports the health centers with line-item budgets irrespective of the number of patients and the quality of care. This paper demonstrates that the efficiency of public health centers increases if the relevance of performance-based financing increases. Thus, the authors recommend increasing performance-based financing in Cambodia to improve value-based healthcare. There are several alternatives available to re-balance demand- and supply-side financing, and all of them must be thoroughly analyzed before they are implemented.


Assuntos
Atenção à Saúde , Academias de Ginástica , Humanos , Camboja , Gastos em Saúde , Instalações de Saúde , Financiamento Governamental
2.
Health Aff (Millwood) ; 42(1): 94-104, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36623227

RESUMO

We estimated immunization program costs, financing, and funding gaps for sixteen vaccines among ninety-four low- and middle-income countries during the period 2011-30. Inputs were obtained from the Institute for Health Metrics and Evaluation, the 2020 Decade of Vaccine Economics costing analysis, the World Health Organization, Gavi, and the United Nations Children's Fund. We found a total funding gap of $38.4 billion between 2011 and 2030, with the cost of immunization delivery being the main driver (86 percent) of the funding gap. On average, government financing of vaccination programs steadily rises throughout the period. However, the decline in both Gavi and development assistance for health (DAH) financing anticipated between 2011 and 2030 outpaces the forecasted increases in domestic government immunization spending. Probabilistic sensitivity analysis was applied to both the costing and the scenario analyses to address uncertainty in the financing of vaccines and vaccine delivery. The results highlight a narrowing gap for vaccine acquisition but a growing gap for vaccine delivery, which emphasizes the critical need for resource mobilization and sustainable financial strategies for immunization programs at national and global levels, as well as a need to address the COVID-19 pandemic's potential effects on government financing for vaccines between 2021 and 2030.


Assuntos
COVID-19 , Vacinas , Criança , Humanos , Países em Desenvolvimento , Pandemias , COVID-19/prevenção & controle , Vacinação , Financiamento Governamental , Programas de Imunização , Saúde Global
6.
JAMA Netw Open ; 5(11): e2243221, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36409499

RESUMO

This cross-sectional study examines changes from 1992 to 2020 in the use of promotional language in National Institutes of Health (NIH) funding opportunity announcements in comparison with trends reported in NIH grant applications.


Assuntos
Idioma , National Institutes of Health (U.S.) , Estados Unidos , Humanos , Financiamento Governamental
8.
Artigo em Inglês | MEDLINE | ID: mdl-36360654

RESUMO

With the increase in the number of waste power batteries and the occurrence of related environmental problems, battery recycling is receiving extensive attention. Driven by economic benefits, many companies have begun to deploy the waste battery processing market and government subsidies also play an essential role in battery recycling. Considering the vehicle company outsources processing tasks or invests in research and development (R&D), this paper studies the optimal decision-making problem of the supply chain under government subsidy to the battery manufacturer or the battery manufacturer. The research finds that: (1) For the government, when the vehicle company outsources processing tasks, compared with subsidizing the vehicle company, the total recycling volume when subsidizing the battery manufacturer is higher. When the vehicle company invests in R&D, the total recycling volume under different government subsidy strategies is equal. (2) The vehicle company's decision is only related to its processing costs; when the unit processing cost is low, the vehicle company's profit under the strategy of investing in R&D is higher. However, when the unit processing cost is high, the profit of outsourcing processing tasks is higher. (3) With increase in unit subsidy and decrease in unit processing cost, the total recycling volume will increase. These findings can provide decision-making help for the government in formulating subsidy policies and the vehicle company in determining processing strategies in the future.


Assuntos
Fontes de Energia Elétrica , Reciclagem , Financiamento Governamental , Governo , Políticas
9.
Artigo em Inglês | MEDLINE | ID: mdl-36360852

RESUMO

Can environmental regulation promote green innovation and the productivity of cities? The "Compliance Cost" (CC) perspective and the "Porter Hypothesis" (PH) offer contrasting views, whereas the existing empirical results are inconclusive. This paper aims to highlight the roles of multifaceted government interventions, including government-to-firm subsidies, tax levies on firms, and environmental infrastructure provisions, in moderating environmental regulation for realizing PH. Based on the fixed-effects models for Chinese prefecture cities from 2005-2013, we found that environmental regulation positively impacted green innovation but negatively affected productivity. The results of moderating effects suggest that environmental regulation can better promote green innovation if it is compounded with more government-to-firm subsidies, lower firm tax burdens, and increased environmental infrastructure provisions. We further decomposed the impacts of these interventions across seven fields of green innovation and found that subsidy and tax burden relief were especially effective in facilitating more GI in the sector of transportation and alternative energy production. This paper amplifies the theoretical framework of PH by accentuating the analytical lens of multifaceted government interventions but also provides insights into how local governments can effectively design "carrot-and-stick" policies to realize PH at the city level.


Assuntos
Eficiência , Governo , Cidades , Governo Local , Regulamentação Governamental , Financiamento Governamental , China
10.
N C Med J ; 83(6): 397, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36344094
11.
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13.
Health Policy ; 126(12): 1226-1232, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36261302

RESUMO

There is a perception that population ageing will have deleterious effects on future health financing sustainability. We propose a new method-the Population Ageing financial Sustainability gap for Health systems (or alternatively, the PASH)-to explore how changes in the population age mix will affect health expenditures and revenues. Using a set of six anonymized country scenarios that are based on data from countries in Europe and the Western Pacific representing a diverse range of health financing systems, we forecast the size of the ageing-attributable gap between health revenues and expenditures from 2020 to 2100 under current health financing arrangements. In the country with the largest financing gap in 2100 (country S6) the majority (87.1%) is caused by growth in health expenditures. However in countries that are heavily reliant on labour-market related social contributions to finance health care, a sizeable share of the financing gap is due to reductions in health revenues. We argue that analyses giving equal attention to both health expenditures and revenues steers decision makers towards a more balanced set of policy options to address the challenges of population ageing, ranging from targeting expenditures and utilization of services to diversifying revenue.


Assuntos
Gastos em Saúde , Financiamento da Assistência à Saúde , Humanos , Serviços de Saúde , Atenção à Saúde , Previsões , Envelhecimento , Financiamento Governamental
16.
Artigo em Inglês | MEDLINE | ID: mdl-36078329

RESUMO

With the development of blockchain, big data, cloud computing and other new technologies, how to achieve innovative development and green sustainable development in digital transformation has become one of the key issues for enterprises to obtain and maintain core competitiveness. However, little of the literature has paid attention to the impact of digital transformation on enterprise green innovation. Using the data of Chinese A-share listed companies from 2010 to 2020, this paper empirically analyzes the impact of enterprise digital transformation on green innovation and its transmission mechanism, by constructing double fixed-effect models. The results show that digital transformation has remarkably promoted the green innovation of enterprises. R&D investment, government subsidies, and income tax burden have played a conductive role between digital transformation and enterprise green innovation. Furthermore, digital transformation can significantly promote the high-quality green innovation of enterprises and also plays a more significant role in promoting the green innovation of high-tech enterprises and state-owned enterprises. A robustness test is carried out by using the lag data and changing the measurement methods of the dependent variable and independent variables, and the research conclusions are still valid. Based on resource-based theory and dynamic capability theory, this paper reveals the impact path of digital transformation on enterprise green innovation, further expanding the research field of digital transformation and enriching the research on the influencing factors of enterprise green innovation. This paper provides policy suggestions for the government to improve the enterprise green innovation level by increasing government subsidies and providing tax incentives and also provides reference for digital transformation enterprises to accelerate green innovation by increasing R&D investment, obtaining government subsidies, and acquiring tax policy support.


Assuntos
Governo , Desenvolvimento Sustentável , China , Financiamento Governamental
17.
Appl Health Econ Health Policy ; 20(5): 681-691, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35917056

RESUMO

OBJECTIVE: Easy and equitable access to testing has been a cornerstone of the public health response to COVID-19. Currently in Australia, testing using polymerase chain reaction (PCR) tests for COVID-19 is free to the user, but government funding for rapid antigen tests (RATs) is limited. We conduct an economic analysis of alternative government policies regarding the funding of COVID-19 testing in Australia. METHODS: A decision tree model was developed to describe COVID-19 testing pathways for the Australian population over a 1-week period. The model outputs were analysed to estimate R numbers associated with alternative funding policies, which were used to estimate COVID-19 cases over a 6-month time horizon. Healthcare costs and quality-adjusted life-year (QALY) effects were applied to new COVID-19 cases. The model was populated using responses to a de novo population survey and published data sources. RESULTS: Compared with no government-funded COVID-19 testing, government-funded testing is estimated to generate large incremental net monetary benefits (INMBs), up to A$15 billion in the base-case analyses. Government-funded PCR testing and RATs for all is predicted to maximise INMBs in most tested scenarios, though funding RATs for all and not PCR tests has similar INMBs in many scenarios and generates higher benefits to costs ratios. CONCLUSIONS: Our interpretation of the modelled analysis is that at the time of writing (July 2022), with high vaccination uptake in Australia and few other public health measures in place, Australian governments should consider reducing funding of PCR testing, for example, limiting capacity to essential workers and individuals with known risk factors for serious symptoms, and fund RATs for all.


Assuntos
Teste para COVID-19 , COVID-19 , Financiamento Governamental , Austrália , COVID-19/diagnóstico , COVID-19/epidemiologia , Teste para COVID-19/economia , Análise Custo-Benefício , Humanos
19.
Environ Manage ; 70(5): 697-709, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36008627

RESUMO

The resilience of public environmental agencies is an important but broadly under-researched discourse. This paper addresses this lacuna by drawing on a three-part typology of resilience from organizational studies and applying it to the English natural environment agency, Natural England, following a decade of public sector agency de-funding under the aegis of austerity. The research question was explored qualitatively through eleven semi-structured interviews with the senior management team of Natural England during the summer of 2020. The findings suggest that public agency multi-functionality equate to heterogenous resilience across agency functions; that generally agency resilience (as a function of capacities) is poor with consequences upon good governance; and that they are broadly poorly positioned for the aftermath of Covid-19. The findings speak directly to the regulatory and organizational literatures with public administration by evidencing the complex realities of understanding resiliencies in large multi-functional public environmental agencies.


Assuntos
Meio Ambiente , Cultura Organizacional , Setor Público , Apoio Financeiro , Financiamento Governamental , Humanos
20.
Vaccine ; 40(39): 5691-5700, 2022 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-36030126

RESUMO

BACKGROUND: Vaccination is a cost-effective disease prevention measure. Sustainable financing is critical to successful implementation of vaccination programs. Countries in the Middle East and Africa (MEA) have vaccination programs that remain highly vulnerable to budget limitations. OBJECTIVES: The objectives of this study were to understand the current vaccine financing landscape in MEA; to assess the availability and variability of data on vaccination budgets, expenditure and schedules including introductions of new vaccines; and to identify and describe key trends. METHOD: A targeted literature review was conducted for 69 MEA countries for data between 2010 and 2019. Descriptive analysis of the collected data was conducted. RESULTS: Data on vaccination expenditure were available for 96% of the countries. However, data on vaccination budget were limited, and the variability was high. The median vaccination expenditure per capita was between US$0.57 and US$1.02. High-income countries spent the most on vaccination per capita (median US$3.41) compared to low-income countries (median US$0.69). The highest vaccination expenditure per capita was in countries that receive 100% government funding of vaccination programs (US$0.87) compared to those where government pays for > 0% to < 50% of vaccination expenditure (US$0.74). Vaccination expenditure as a proportion of gross domestic product was the highest (0.10%) in low-income countries and the lowest in high-income countries (0.01%). Vaccination expenditure as proportion of healthcare expenditure was the highest (1.76%) in low-income countries and the lowest in high-income countries (0.33%). Statistically significant trends in median expenditure per capita were identified for 27% of the countries. During this period, an average of 4.4 vaccines were introduced. CONCLUSION: Data on vaccination expenditure in MEA was available for detailed analysis, and it was useful to understand the characteristics of vaccination funding in the region. It is important to secure adequate financing to sustain current vaccination programs and to introduce new vaccines.


Assuntos
Países em Desenvolvimento , Vacinas , África , Financiamento Governamental , Programas de Imunização , Vacinação
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