Rai Pramila, O'Connor Denise A, N Ackerman Ilana, Buchbinder Rachelle
Monash University, Melbourne, VIC Australia.
JNMA J Nepal Med Assoc. 2024 Apr 30;62(273):347-349. doi: 10.31729/jnma.8584.
The burden of chronic diseases in Nepal is increasing due to demographic and epidemiological transitions; alongside the persistent impact of communicable, maternal, newborn, and child health diseases, this critical situation acts as the precursor to rising healthcare costs. Nepal struggles to sustain its healthcare system amidst political instability, pandemics, natural disasters, and slow economic growth, particularly when healthcare funding is mainly dependent on out-of-pocket payments. Nepal requires lower-cost alternative healthcare delivery arrangements to provide high-value care while relieving economic sustainability pressures. Alternative healthcare delivery arrangements have a broad potential scope; they can involve strategic changes in how care is delivered and by whom, or they can also involve the application of information and communication technologies, e.g., telemedicine. This paper highlights the specific challenges to healthcare system sustainability in Nepal and the potential for high-value, lower-cost alternative healthcare delivery models to improve system performance in the longer term.
由于人口结构和流行病学转变,尼泊尔慢性病负担日益加重;除了传染病、孕产妇、新生儿和儿童健康疾病的持续影响外,这一严峻形势还成为医疗成本上升的先兆。尼泊尔在政治不稳定、大流行病、自然灾害和经济增长缓慢的情况下,难以维持其医疗体系,特别是在医疗资金主要依赖自费支付的情况下。尼泊尔需要低成本的替代医疗服务安排,以提供高价值的护理,同时缓解经济可持续性压力。替代医疗服务安排具有广泛的潜在范围;它们可以涉及护理提供方式和提供者的战略变革,也可以涉及信息和通信技术的应用,如远程医疗。本文强调了尼泊尔医疗体系可持续性面临的具体挑战,以及高价值、低成本的替代医疗服务模式在长期改善体系绩效方面的潜力。