Yerevan State Medical University (YSMU), 2 Koryun str., Yerevan 0025, Republic of Armenia.
Int J Equity Health. 2012 Jun 13;11:32. doi: 10.1186/1475-9276-11-32.
Prevailing sociopolitical and economic obstacles have been implicated in the inadequate utilization and delivery of the Armenian health care system.
A random survey of 1,000 local residents, from all administrative regions of Armenia, concerned with health care services cost and satisfaction was conducted. Participation in the survey was voluntary and the information was collected using anonymous telephone interviews.
The utilization of health care services was low, particularly in rural areas. This under-utilization of services correlated with low income of the population surveyed. The state funded health care services are inadequate to ensure availability of free-of-charge services even to economically disadvantaged groups. Continued reliance on direct out-of pocket and illicit payments, for medical services, are serious issues which plague healthcare, pharmaceutical and medical technology sectors of Armenia.
Restructuring of the health care system to implement a cost-effective approach to the prevention and treatment of diseases, especially disproportionately affect the poor, should be undertaken. Public payments, increasing the amount of subsidies for poor and lower income groups through a compulsory health insurance system should be evaluated and included as appropriate in this health system redesign. Current medical services reimbursement practices undermine the principle of equity in financing and access. Measures designed to improve healthcare access and affordability for poor and disadvantaged households should be enacted.
普遍存在的社会政治和经济障碍被认为是亚美尼亚医疗保健系统利用不足和服务提供不足的原因。
对亚美尼亚所有行政区的 1000 名当地居民进行了一项关于医疗保健服务成本和满意度的随机调查。参与调查是自愿的,信息是通过匿名电话访谈收集的。
医疗服务的利用率很低,特别是在农村地区。这种服务利用率低与调查人群的低收入有关。国家资助的医疗保健服务不足以确保即使是经济弱势群体也能获得免费服务。继续依赖直接自掏腰包和非法支付医疗费用是困扰亚美尼亚医疗保健、制药和医疗技术部门的严重问题。
应进行医疗保健系统的重组,以实施一种针对疾病预防和治疗的具有成本效益的方法,特别是那些对贫困人口产生不成比例影响的方法。公共支出应通过强制性健康保险制度增加对贫困和低收入群体的补贴数额,并在适当情况下纳入这一卫生系统重新设计。当前的医疗服务报销做法破坏了筹资和获得方面的公平原则。应制定旨在改善贫困和弱势家庭获得和负担得起医疗服务的措施。