伊朗克尔曼省的卫生账户：“混合”医疗保健融资体系的证据。

Provincial health accounts in Kerman, Iran: an evidence of a "mixed" healthcare financing system.

机构信息

Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

Research Center for Health Services Provision Management, Kerman University of Medical Sciences, General Department of Medical Insurance Services, Kerman, Iran.

出版信息

Int J Health Policy Manag. 2014 Feb 23;2(2):69-74. doi: 10.15171/ijhpm.2014.17. eCollection 2014 Feb.

DOI:10.15171/ijhpm.2014.17

PMID:24639980

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3952539/

Abstract

BACKGROUND

Provincial Health Accounts (PHA) as a subset of National Health Accounts (NHA) present financial information for health sectors. It leads to a logical decision making for policy-makers in order to achieve health system goals, especially Fair Financial Contribution (FFC). This study aimed to examine Health Accounts in Kerman Province.

METHODS

The present analytical study was carried out retrospectively between 2008 and 2011. The research population consisted of urban and rural households as well as providers and financial agents in health sectors of Kerman Province. The purposeful sampling included 16 provincial organizations. To complete data, the report on Kerman household expenditure was taken as a data source from the Governor-General's office. In order to classify the data, the International Classification for Health Accounts (ICHA) method was used, in which data set was adjusted for the province.

RESULTS

During the study, the governmental and non-governmental fund shares of the health sector in Kerman were 27.22% and 72.78% respectively. The main portion of financial sources (59.41) was related to private household funds, of which the Out-of-Pocket (OOP) payment mounted to 92.35%. Overall, 54.86% of all financial sources were covered by OOP. The greatest portion of expenditure of Total Healthcare Expenditures (THEs) (65.19%) was related to curative services.

CONCLUSION

The major portion of healthcare expenditures was related to the OOP payment which is compatible with the national average rate in Iran. However, health expenditure per capita, was two and a half times higher than the national average. By emphasizing on Social Determinant of Health (SDH) approach in the Iranian health system, the portion of OOP payment and curative expenditure are expected to be controlled in the medium term. It is suggested that PHA should be examined annually in a more comprehensive manner to monitor initiatives and reforms in healthcare sector.

摘要

背景

省级卫生账户（PHA）作为国家卫生账户（NHA）的一个子集，提供卫生部门的财务信息。这为决策者提供了合乎逻辑的决策依据，以实现卫生系统目标，特别是公平的财政贡献（FFC）。本研究旨在检查克尔曼省的卫生账户。

方法

本回顾性分析研究于 2008 年至 2011 年进行。研究人群包括克尔曼省城乡家庭以及卫生部门的提供者和金融机构。采用目的抽样法，选取了 16 个省级组织。为了完成数据收集，从省长办公室的报告中获取了克尔曼家庭支出报告作为数据来源。为了对数据进行分类，采用了国际卫生账户分类（ICHA）方法，并对省级数据进行了调整。