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卫生服务筹资与提供:阿拉伯联合酋长国迪拜的政策选择分析

Health services financing and delivery: analysis of policy options for Dubai, United Arab Emirates.

作者信息

Hamidi Samer

机构信息

School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates.

出版信息

Clinicoecon Outcomes Res. 2015 Feb 25;7:133-43. doi: 10.2147/CEOR.S75743. eCollection 2015.

Abstract

INTRODUCTION

A national health account (NHA) provides a systematic approach to mapping the flow of health sector funds within a specified health system over a defined time period. This article attempts to present a profile of health system financing in Dubai, United Arab Emirates using data from NHAs, and to compare the functional structures of financing schemes in Dubai with schemes in Qatar and selected member countries of the Organization for Economic Cooperation and Development (OECD).

METHODS

The author analyzed secondary data published in NHAs of Dubai and Qatar and data collected by the OECD countries and publicly available from Eurostat (Statistical Office of the European Union) of 25 OECD countries for comparative analysis. All health financing indicators used were as defined in the international System of Health Accounts (SHA).

RESULTS

In Dubai, spending on inpatient care was the highest-costing component, with 30% of current health expenditures (CHE). Spending on outpatient care was the second highest-costing component and accounted for about 23% of the CHE. Household spending accounted for about 22% of CHE (equivalent to US$187 per capita), compared to an average of 20% of CHE of OECD countries. Dubai spent 0.02% of CHE on long-term care, compared to an average of 11% of CHE of OECD countries. Dubai spent about 6% of CHE on prevention and public health services, compared to an average of 3.2% of CHE of OECD countries.

CONCLUSION

The findings point to potential opportunities for growth and improvement in several health policy issues in Dubai, including increasing focus and funding of preventive services; shifting from inpatient care to day surgery, outpatient, and home-based services and strengthening long-term care; and introducing cost-containment measures for pharmaceuticals. More investment in the translation of NHA data into policy is suggested for future researchers.

摘要

引言

国家卫生账户(NHA)提供了一种系统方法,用于描绘特定卫生系统在规定时间段内卫生部门资金的流动情况。本文试图利用国家卫生账户的数据,呈现阿拉伯联合酋长国迪拜卫生系统融资的概况,并将迪拜融资计划的功能结构与卡塔尔以及经济合作与发展组织(经合组织)选定成员国的计划进行比较。

方法

作者分析了迪拜和卡塔尔国家卫生账户中公布的二手数据,以及经合组织国家收集并可从欧盟统计局(欧盟统计办公室)公开获取的25个经合组织国家的数据,进行比较分析。所使用的所有卫生融资指标均按照国际卫生账户体系(SHA)的定义。

结果

在迪拜,住院护理支出是成本最高的组成部分,占当前卫生支出(CHE)的30%。门诊护理支出是成本第二高的组成部分,约占CHE的23%。家庭支出约占CHE的22%(人均相当于187美元),而经合组织国家的平均水平为CHE的20%。迪拜在长期护理上的支出占CHE的0.02%​​,而经合组织国家的平均水平为CHE的11%。迪拜在预防和公共卫生服务上的支出约占CHE的6%,而经合组织国家的平均水平为CHE的3.2%。

结论

研究结果指出了迪拜在若干卫生政策问题上的潜在增长和改进机会,包括加强对预防服务的关注和资金投入;从住院护理转向日间手术、门诊和居家服务,并加强长期护理;以及引入药品成本控制措施。建议未来的研究人员更多地投入将国家卫生账户数据转化为政策的工作。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a139/4348058/191a42e9ea7d/ceor-7-133Fig1.jpg

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