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一项试点全民健康覆盖计划对医院工作量的影响:肯尼亚两个县的比较研究。

The effect of a pilot universal health coverage program on hospital workload: A comparative study of two counties in Kenya.

作者信息

Njuguna John

机构信息

Mukurweini sub-County Public Health Office, Nyeri County, Kenya.

出版信息

Dialogues Health. 2023 Jan 7;2:100100. doi: 10.1016/j.dialog.2023.100100. eCollection 2023 Dec.

Abstract

AIM

Universal health coverage (UHC) aims to provide individuals with the healthcare they need without predisposing them to catastrophic health expenditures. The Kenyan government piloted UHC in four select counties in 2019. Nyeri County was one of the selected counties. Area residents accessed health services from government-owned health facilities at no cost. This study assessed the effect of this pilot on the workload of major health facilities in Nyeri.

MATERIAL AND METHODS

The monthly workload of six health facilities in Nyeri was compared with that of similar facilities in the non-participating county of Embu. A difference-in - differences analysis was done for workload indicators. Workload was downloaded from the Kenya health information system. The level 5 hospital recorded an increase in eight workload indicators with four having statistically significant increases. Three indicators recorded non-significant declines. The level 4 and 3 health facilities also recorded an increase in outpatient workload.

CONCLUSION

The pilot UHC program increased workload and by extension utilization of healthcare among major health facilities in Nyeri.

摘要

目的

全民健康覆盖(UHC)旨在为个人提供所需的医疗保健服务,同时避免他们承担灾难性的医疗费用。肯尼亚政府于2019年在四个选定的县试点实施全民健康覆盖。内罗毕县是选定的县之一。当地居民可免费从政府所有的医疗机构获得医疗服务。本研究评估了该试点对内罗毕主要医疗机构工作量的影响。

材料与方法

将内罗毕六家医疗机构的月工作量与未参与试点的恩布县类似机构的月工作量进行比较。对工作量指标进行了双重差分分析。工作量数据从肯尼亚卫生信息系统下载。5级医院的八项工作量指标有所增加,其中四项有统计学意义的显著增加。三项指标出现非显著下降。4级和3级医疗机构的门诊工作量也有所增加。

结论

全民健康覆盖试点项目增加了内罗毕主要医疗机构的工作量,并进而提高了医疗保健的利用率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee77/10953853/e20ea0f8cfb0/gr1.jpg

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