Carrin Guy, Waelkens Maria-Pia, Criel Bart
Department of Health Financing, Expenditure and Resource Allocation, World Health Organisation, Geneva, Switzerland.
Trop Med Int Health. 2005 Aug;10(8):799-811. doi: 10.1111/j.1365-3156.2005.01455.x.
We studied the potential of community-based health insurance (CHI) to contribute to the performance of health financing systems. The international empirical evidence is analysed on the basis of the three health financing subfunctions as outlined in the World Health Report 2000: revenue collection, pooling of resources and purchasing of services. The evidence indicates that achievements of CHI in each of these subfunctions so far have been modest, although many CHI schemes still are relatively young and would need more time to develop. We present an overview of the main factors influencing the performance of CHI on these financing subfunctions and discuss a set of proposals to increase CHI performance. The proposals pertain to the demand for and the supply of health care in the community; to the technical, managerial and institutional set-up of CHI; and to the rational use of subsidies.
我们研究了基于社区的健康保险（CHI）对卫生筹资系统绩效的贡献潜力。根据《2000年世界卫生报告》概述的三个卫生筹资子功能，即收入筹集、资源统筹和服务购买，对国际实证证据进行了分析。证据表明，到目前为止，CHI在每个子功能方面取得的成就都较为有限，尽管许多CHI计划仍相对年轻，需要更多时间来发展。我们概述了影响CHI在这些筹资子功能上绩效的主要因素，并讨论了一系列提高CHI绩效的建议。这些建议涉及社区卫生保健的需求和供给；CHI的技术、管理和机构设置；以及补贴的合理使用。
