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Health care financing Case study

Health care financing Case study. GROUP II. Contents. Scrutinizing the health care financing system Collection Pooling Purchasing Overview on health care financing in Emrovia Suggested solutions. Collection. Total expenditure on health = $1.2 billion

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Health care financing Case study

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  1. Health care financingCase study GROUP II

  2. Contents • Scrutinizing the health care financing system • Collection • Pooling • Purchasing • Overview on health care financing in Emrovia • Suggested solutions

  3. Collection • Total expenditure on health = $1.2 billion • Total health expenditure per capita = $24 • % of health expenditure / total government budget = 3.2% • % of health expenditure / GDP = 2.7% • Out-of-pocket expenditure = $ 844.3 M = 70% of total expenditure

  4. Pooling • Aprox. 9% of population insured • For uncovered population: Average visits to MOH facilities per person per year 0.7 • In Civil Servants Health Insurance Scheme: $12.5 per person per year • In private health insurance: $ 19 per person per year

  5. Pooling (cont’d) • Distribution of facilities (per capita): • 20 times more facilities in capital than east • 48 times more facilities in capital than west • Public health services are under-utilized No of beds Admission 80% of HCWs 20% of HCWs

  6. Purchasing • Almost 50% out-of-pocket expenditure on medicines • For civil servants scheme: • 60% of hospital care abroad • 23% in private facilities • Only 17% in public hospitals • Civil Servants and private insurance schemes are under-funded perhaps high co-payments

  7. Overview • Low government budget • Public sector paying about 65% of costs in clinics and 96% in hospitals • Emphasis on secondary and tertiary care rather than primary care • Low number of people (9%) have limited social protection • Share of GDP allocated to health is very limited (even for LIC)

  8. Recommendations • Government should allocate more resources to primary health care especially in rural areas and the west • Advocate for primary health care approach • More equitable distribution of health facilities • Improve quality of care in public facilities • Incentives to health care providers to go west/rural (e.g. % of revenues) • Decrease travel abroad for inpatient care • Explore high expenditures on medicines: • Generics – EML - formulary – unified/central procurement (e.g. Egypt saved 400M on meds)

  9. Recommendations (cont’d) • Research on health-seeking-behaviours of uninsured population: • Who are providing services (traditional healers, faith-based NGOs, TBAs/midwives, etc.) • Utilization • Explore community-based health insurance • Intermediate measure: Strengthen existing mechanisms • Long-term: Formulate strategic plan for improving health system

  10. Thank you

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