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[1980年至2012年布基纳法索的卫生系统收入征收情况]

[Health system revenue collection in Burkina Faso from 1980 to 2012].

作者信息

Ridde Valéry, Belaid Loubna, Samb Oumar Mallé, Faye Adama

出版信息

Sante Publique. 2014 Sep-Oct;26(5):715-25.

PMID:25490231
Abstract

As a step towards universal health coverage, African countries need to develop funding systems that are effective, equitable, and tailored to national circumstances. To support policy makers in Burkina Faso, we present a review of research on interventions related to user fees, prepayment plans, and user fee subsidies. We compiled a narrative summary of articles published in scientific journals between 1980 and 2012. In all, 64 articles were selected. A thematic analysis was performed. User fees are a barrier to access to care; they curtail the use of health services and exclude the worst-off. People prefer prepayment plans in which each household pays an annual premium. However, the insurance premium remains a barrier to membership. Insurance does not benefit the poor but increases the use of health services by the insured. The subsidy for facility-based deliveries was not sufficiently well planned and difficulties have been observed in its implementation. While it helps reduce costs and improves access to care, it has not reduced inequalities. Community-based and participatory interventions have been useful for identifying the worst-off in order to exempt them from user fees. While prepayment is being promoted internationally as a financing model for universal health coverage, the evidence in favour of this system in Burkina Faso is still very limited. Further studies, more representative of the national context, must be conducted on this option, while at the same time, continuing efforts must be made to identify solutions for the poor who are unable to pay.

摘要

作为迈向全民健康覆盖的一步,非洲国家需要建立有效、公平且符合国情的筹资体系。为了支持布基纳法索的政策制定者,我们对与使用者付费、预付计划和使用者付费补贴相关的干预措施研究进行了综述。我们编写了1980年至2012年间发表在科学期刊上的文章的叙述性总结。总共筛选出64篇文章,并进行了主题分析。使用者付费是获得医疗服务的障碍;它限制了医疗服务的使用,并将最贫困人群排除在外。人们更喜欢每户支付年度保费的预付计划。然而,保险费仍然是参保的障碍。保险并未使穷人受益,但增加了参保者对医疗服务的使用。基于设施分娩的补贴规划不够完善,在实施过程中出现了困难。虽然它有助于降低成本并改善医疗服务的可及性,但并未减少不平等现象。基于社区和参与性的干预措施有助于识别最贫困人群,以便免除他们的使用者付费。虽然预付作为全民健康覆盖的一种筹资模式在国际上得到推广,但在布基纳法索支持这一体系的证据仍然非常有限。必须针对这一选项开展更能代表国家情况的进一步研究,同时,必须继续努力为无力支付费用的穷人找到解决办法。

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1
[Health system revenue collection in Burkina Faso from 1980 to 2012].[1980年至2012年布基纳法索的卫生系统收入征收情况]
Sante Publique. 2014 Sep-Oct;26(5):715-25.
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The unintended consequences of combining equity measures with performance-based financing in Burkina Faso.布基纳法索将公平措施与基于绩效的融资相结合的意外后果。
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User fee exemptions and excessive household spending for normal delivery in Burkina Faso: the need for careful implementation.用户付费豁免和布基纳法索正常分娩的过度家庭支出:需要谨慎实施。
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Free versus subsidised healthcare: options for fee exemptions, access to care for vulnerable groups and effects on the health system in Burkina Faso.免费医疗与补贴医疗:布基纳法索的费用豁免选项、弱势群体的医疗服务获取情况及其对卫生系统的影响
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[Health staff workload in a context of user fees exemption policy for health care in Burkina Faso and Niger].[布基纳法索和尼日尔医疗保健用户费用豁免政策背景下的卫生工作人员工作量]
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Financial accessibility and user fee reforms for maternal healthcare in five sub-Saharan countries: a quasi-experimental analysis.撒哈拉以南五个国家孕产妇保健的财务可及性与使用者付费改革:一项准实验分析
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A community-based targeting approach to exempt the worst-off from user fees in Burkina Faso.在布基纳法索,以社区为基础的目标定位方法使最贫困人群免受用户付费的影响。
J Epidemiol Community Health. 2010 Jan;64(1):10-5. doi: 10.1136/jech.2008.086793.
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Ethical considerations related to participation and partnership: an investigation of stakeholders' perceptions of an action-research project on user fee removal for the poorest in Burkina Faso.与参与和伙伴关系相关的伦理考量:对利益相关者对布基纳法索一项关于为最贫困人口取消用户费用的行动研究项目的看法的调查。
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引用本文的文献

1
Inequities and their determinants in coverage of maternal health services in Burkina Faso.布基纳法索孕产妇卫生服务覆盖方面的不平等及其决定因素。
Int J Equity Health. 2018 May 11;17(1):58. doi: 10.1186/s12939-018-0770-8.
2
A study on the implementation fidelity of the performance-based financing policy in Burkina Faso after 12 months.布基纳法索基于绩效的融资政策实施12个月后的实施保真度研究。
Arch Public Health. 2018 Jan 11;76:4. doi: 10.1186/s13690-017-0250-4. eCollection 2018.
3
Street-level workers' inadequate knowledge and application of exemption policies in Burkina Faso jeopardize the achievement of universal health coverage: evidence from a cross-sectional survey.
布基纳法索基层工作者对豁免政策的了解和应用不足,危及全民健康覆盖目标的实现:来自横断面调查的证据。
Int J Equity Health. 2018 Jan 8;17(1):5. doi: 10.1186/s12939-017-0717-5.
4
Presence of three dengue serotypes in Ouagadougou (Burkina Faso): research and public health implications.瓦加杜古(布基纳法索)三种登革热血清型的存在:研究及对公共卫生的影响
Infect Dis Poverty. 2016 Apr 5;5:23. doi: 10.1186/s40249-016-0120-2.