The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, United States of America.
Health Economics Directorate, Ministry of Health, Amman, Jordan.
East Mediterr Health J. 2020 Feb 24;26(2):206-211. doi: 10.26719/2020.26.2.206.
Achieving universal health coverage is a strategic goal for the Government of Jordan. Estimating the cost of expanding health coverage to vulnerable Jordanians under the Civil Insurance Programme (CIP) is an important step towards achieving this goal.
This study aimed to estimate the cost and fiscal impact of expanding health insurance coverage to vulnerable Jordanians.
We identified and quantified vulnerable Jordanians and estimated their utilization and cost of health services provided at Ministry of Health facilities using allocation and macrocosting approaches. We calculated the annual actuarial cost per person and the fiscal impact of the expansion.
It was estimated that 4.9% of Jordanians were vulnerable. On average, a vulnerable Jordanian used 1.25 ambulatory visits and 0.027 admissions fewer annually than a person insured by CIP. The annual cost (US$ 79 million) and fiscal impact (US$ 73 million) of expanding coverage to vulnerable Jordanians were due to more ambulatory services (20%) and hospitalizations (80%).
A combination of additional resources and improvement in system efficiencies may fund this expansion.
实现全民健康覆盖是约旦政府的战略目标。估算通过民事保险计划（CIP）为弱势约旦人扩大健康保险覆盖范围的成本，是实现这一目标的重要步骤。
本研究旨在估算扩大健康保险覆盖弱势约旦人的成本和财政影响。
我们确定并量化了弱势约旦人，并使用分配和宏观成本核算方法估算了他们在卫生部设施中使用卫生服务的利用情况和成本。我们计算了每人的年度精算成本和扩大覆盖范围的财政影响。
据估计，4.9%的约旦人属于弱势群体。与 CIP 保险的人相比，弱势约旦人每年的门诊就诊次数平均减少 1.25 次，住院次数减少 0.027 次。扩大弱势约旦人保险覆盖范围的年度成本（7900 万美元）和财政影响（7300 万美元）归因于更多的门诊服务（20%）和住院服务（80%）。
额外资源的组合和系统效率的提高可能为这一扩展提供资金。
