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韩国全民健康覆盖的历史遗产:迈向乌干达的健康覆盖和财务保护 评论“乌干达的健康覆盖和财务保护:政治经济学视角”。

A Historical Legacy for Universal Health Coverage in the Republic of Korea: Moving Towards Health Coverage and Financial Protection in Uganda Comment on "Health Coverage and Financial Protection in Uganda: A Political Economy Perspective".

机构信息

Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.

Hongcheon County Hypertension and Diabetes Registration and Education Center, Hongcheon, South Korea.

出版信息

Int J Health Policy Manag. 2023;12:7434. doi: 10.34172/ijhpm.2023.7434. Epub 2023 Feb 13.

Abstract

Since 2001, when Uganda abolished user fees to improve the accessibility of healthcare, out-of-pocket costs still account for 42% of total health expenditure. Even if universal health coverage (UHC) is achieved on the demand-side, government authorities face political and economic challenges due to soaring burden of diseases. Therefore, this study aimed to re-analyze the implementation process according to three pillars by World Health Organization (WHO) based on Korean UHC-related articles. In terms of breadth, the national health insurance (NHI) in Korea UHC was established from 1977 for employees to 1989 for self-employed. In terms of depth, benefit packages in Korea UHC have expanded from essential medical services to expensive care (ultrasono, computerized tomography, etc) including benefit period. Finally, in terms of height of coverage, the government has tried to relieve financial burden of households with catastrophes and enhance benefit plan for major diseases till now. This historical legacy for UHC in Korea can pose lessons to policy-makers in developing countries including Uganda and Ghana.

摘要

自 2001 年乌干达取消医疗服务收费以提高医疗保健的可及性以来,自费仍然占总医疗支出的 42%。即使在需求方面实现了全民健康覆盖(UHC),由于疾病负担的飙升,政府当局仍然面临政治和经济方面的挑战。因此,本研究旨在根据世界卫生组织(WHO)的三个支柱重新分析韩国与 UHC 相关的文章的实施过程。从广度上讲,韩国 UHC 的国家健康保险(NHI)从 1977 年为员工建立,到 1989 年为自雇人士建立。从深度上讲,韩国 UHC 的福利套餐从基本医疗服务扩大到昂贵的护理(超声、计算机断层扫描等),包括受益期。最后,在覆盖范围的高度上,政府一直试图减轻灾难性家庭的经济负担,并加强重大疾病的福利计划。韩国在 UHC 方面的这一历史遗产可以为包括乌干达和加纳在内的发展中国家的政策制定者提供借鉴。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3ea/10125087/fb9fc48ee4e5/ijhpm-12-7434-g001.jpg

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