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分析全民健康付费政策的财政可持续性:以布基纳法索为例的快速初步评估方法。

Analyzing the Financial Sustainability of User Fee Removal Policies: A Rapid First Assessment Methodology with a Practical Application for Burkina Faso.

机构信息

University Clermont Auvergne and FERDI (Fondation pour les Etudes et Recherches sur le Développement International), 63 Bd François Mitterrand, 63000, Clermont-Ferrand, France.

University Clermont Auvergne, CERDI (Centre d'Etudes et de Recherches sur le Développement International), 26, Avenue Léon Blum, 63000, Clermont-Ferrand, France.

出版信息

Appl Health Econ Health Policy. 2020 Dec;18(6):767-780. doi: 10.1007/s40258-019-00506-2.


DOI:10.1007/s40258-019-00506-2
PMID:31432456
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7716817/
Abstract

The purpose of this paper is to briefly present a methodological framework that does not require cumbersome investigations for a first assessment of the financial sustainability of policies aiming to remove or reduce healthcare user fees (the so-called free healthcare policy [FHCP]). This paper is organized in two main sections. The first analyzes the various possibilities available to finance an FHCP. Using several scenarios, it includes a special focus devoted to the calculus of what to consider when assessing the sustainability of expanding fiscal space for financing the FHCP. The second section relies on the current FHCP being implemented in Burkina Faso to illustrate a selection of specific issues raised in the methodological framework. The results suggest that sustainable FHCP financing is not outside the range of the government but does represent a significant challenge, as it will require, both currently and in the future, complex and delicate budget trade-offs at the highest governmental levels, regardless of other policy options to be considered.

摘要

本文旨在简要介绍一种方法框架,该框架无需进行繁琐的调查,即可对旨在取消或降低医疗保健用户费用的政策的财务可持续性进行初步评估(即所谓的免费医疗保健政策[FHCP])。本文分为两个主要部分。第一部分分析了为 FHCP 融资提供的各种可能性。通过几种方案,本文特别关注在评估扩大财政空间以资助 FHCP 的可持续性时需要考虑的因素。第二部分以布基纳法索目前正在实施的 FHCP 为例,说明了方法框架中提出的一些具体问题。结果表明,可持续的 FHCP 融资并非超出政府能力范围,但确实是一个重大挑战,因为无论未来如何,目前和未来都需要在最高政府层面进行复杂而微妙的预算权衡,而无需考虑其他政策选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d623/7716817/c928f0d57960/40258_2019_506_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d623/7716817/4e72c2d78ff8/40258_2019_506_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d623/7716817/c928f0d57960/40258_2019_506_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d623/7716817/4e72c2d78ff8/40258_2019_506_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d623/7716817/c928f0d57960/40258_2019_506_Fig2_HTML.jpg

相似文献

[1]
Analyzing the Financial Sustainability of User Fee Removal Policies: A Rapid First Assessment Methodology with a Practical Application for Burkina Faso.

Appl Health Econ Health Policy. 2020-12

[2]
Free versus subsidised healthcare: options for fee exemptions, access to care for vulnerable groups and effects on the health system in Burkina Faso.

Health Res Policy Syst. 2017-7-12

[3]
Effect of the free healthcare policy on socioeconomic inequalities in care seeking for fever in children under five years in Burkina Faso: a population-based surveys analysis.

Int J Equity Health. 2022-9-1

[4]
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[5]
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.

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[6]
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[7]
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[8]
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Int J Health Policy Manag. 2022-5-1

[9]
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[10]
Immediate and sustained effects of user fee exemption on healthcare utilization among children under five in Burkina Faso: A controlled interrupted time-series analysis.

Soc Sci Med. 2017-4

引用本文的文献

[1]
Can "the expanded free maternity services" enable Kenya to achieve universal health coverage by 2030: qualitative study on experiences of mothers and healthcare providers.

Front Health Serv. 2024-9-10

[2]
How do free healthcare policies impact utilization of maternal and child health services in fragile settings? Evidence from a controlled interrupted time series analysis in Burkina Faso.

Health Policy Plan. 2024-10-15

[3]
Do Out-of-Pocket Payments for Care for Children under 5 Persist Even in a Context of Free Healthcare in Burkina Faso? Evidence from a Cross-Sectional Population-Based Survey.

Healthcare (Basel). 2023-5-10

[4]
Trends in out-of-pocket expenditure on facility-based delivery and financial protection of health insurance: findings from Vietnam's Household Living Standard Survey 2006-2018.

Int J Health Econ Manag. 2023-6

[5]
Examining the implementation of the Linda Mama free maternity program in Kenya.

Int J Health Plann Manage. 2021-11

[6]
Health Financing in Sub-Saharan Africa: From Analytical Frameworks to Empirical Evaluation.

Appl Health Econ Health Policy. 2020-12

本文引用的文献

[1]
The impact of user charges on health outcomes in low-income and middle-income countries: a systematic review.

BMJ Glob Health. 2019-1-10

[2]
Sustainability of public health interventions: where are the gaps?

Health Res Policy Syst. 2019-1-15

[3]
The impact of reducing and eliminating user fees on facility-based delivery: a controlled interrupted time series in Burkina Faso.

Health Policy Plan. 2018-10-1

[4]
Can Low- and Middle-Income Countries Increase Domestic Fiscal Space for Health: A Mixed-Methods Approach to Assess Possible Sources of Expansion.

Health Syst Reform. 2018-6-1

[5]
Implementation of the free maternity services policy and its implications for health system governance in Kenya.

BMJ Glob Health. 2017-11-12

[6]
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Cochrane Database Syst Rev. 2017-9-11

[7]
Developing a comprehensive definition of sustainability.

Implement Sci. 2017-9-2

[8]
Removing user fees for health services: A multi-epistemological perspective on access inequities in Senegal.

Soc Sci Med. 2017-7-6

[9]
Perceived challenges to achieving universal health coverage: a cross-sectional survey of social health insurance managers/administrators in China.

BMJ Open. 2017-6-2

[10]
Catastrophic healthcare expenditure and poverty related to out-of-pocket payments for healthcare in Bangladesh-an estimation of financial risk protection of universal health coverage.

Health Policy Plan. 2017-10-1

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