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  • 1
    Online Resource
    Online Resource
    Washington, D.C., : The World Bank,
    UID:
    almafu_9958097435102883
    Format: 1 online resource (23 pages)
    Series Statement: Policy research working papers.
    Content: This paper examines the determinants of child nutritional status in seven provinces of China during the 1990s, focusing specifically on the role of two areas of public policy, namely health system reforms and the one child policy. The empirical relationship between income and nutritional status, and the extent to which that relationship is mediated by access to quality healthcare and being an only-child, is investigated using ordinary least squares, random effects, fixed effects, and instrumental variables models. In the preferred model - a fixed effects model where income is instrumented - the author find that being an only-child increases height-for-age z-scores by 0.119 of a standard deviation. The magnitude of this effect is found to be largely gender and income neutral. By contrast, access to quality healthcare and income is not found to be significantly associated with improved nutritional status in the preferred model. Data are drawn from four waves of the China Health and Nutrition Survey.
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 2
    UID:
    almafu_9958099259502883
    Format: 1 online resource (36 pages)
    Series Statement: Policy research working papers.
    Content: This paper explores the major challenges to the sustainability of health sector financing in the countries of the Western Balkans - Albania, Bosnia and Herzegovina, the Former Yugoslav Republic of Macedonia, Montenegro, Serbia and the province of Kosovo. It focuses on how the incentives created by the different elements of the healthcare financing system affect the behavior of healthcare providers and individuals, and the resulting inefficiencies in revenue collection and expenditure containment. The paper analyzes patterns of healthcare expenditure, finding that there is some evidence of cost containment, but that current expenditure levels - while similar to that in EU countries as a share of GDP - are low in per capita terms and the fiscal space to increase expenditures is extremely limited. It also examines the key drivers of current healthcare expenditure and the most significant barriers to revenue generation, identifying some key health reforms that countries in the sub-region could consider in order to enhance the efficiency and sustainability of their health systems. Data are drawn from international databases, country institutions, and household surveys.
    Language: English
    URL: Volltext  (URL des Erstveröffentlichers)
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 3
    UID:
    almafu_9958099245602883
    Format: 1 online resource (33 pages)
    Series Statement: Policy research working papers.
    Content: This paper investigates the extent to which the health systems of the Western Balkans (Albania, Bosnia and Herzegovina, Montenegro, Serbia, and Kosovo) have succeeded in providing financial protection against adverse health events. The authors examine disparities in health status, healthcare utilization, and out-of-pocket payments for healthcare (including informal payments), and explore the impact of healthcare expenditures on household economic status and poverty. Methodologies include (i) generating a descriptive assessment of health and healthcare disparities across socioeconomic groups, (ii) measuring the incidence and intensity of catastrophic healthcare payments, (iii) examining the effect of out-of-pocket payments on poverty headcount and poverty gap measures, and (iv) running sets of country-specific probit regressions to model the relationship between health status, healthcare utilization, and poverty. On balance, the findings show that the impact of health expenditures on household economic wellbeing and poverty is most severe in Albania and Kosovo, while Montenegro is striking for the financial protection that the health system seems to provide. Data are drawn from Living Standards and Measurement Surveys.
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 4
    UID:
    almafu_9958246520102883
    Format: 1 online resource (29 pages)
    Series Statement: Policy research working papers.
    Content: Providing protection against the financial risk of high out-of-pocket health spending is one of the main goals of the Philippines' health strategy. Yet, as this paper shows using eight household surveys, health spending increased by 150 percent (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has trebled since 2000, from 2.5 to 7.7 percent. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance for the poor, a deepening of the benefit package, and provider payment reform aimed at cost-containment-are to be applauded. Between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, possible quick wins could include issuing health insurance cards for the poor to increase awareness of coverage and introducing a fixed copayment for non-poor members. Over the medium term, complementary investments in supply-side readiness are essential. Finally, an in-depth analysis of the pharmaceutical sector would help to shed light on why medicines continue to place such a large financial burden on households.
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
    URL: Volltext  (kostenfrei)
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  • 5
    UID:
    almahu_9949191564402882
    Format: 1 online resource (66 pages)
    Series Statement: International Development in Focus
    Content: This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.
    Additional Edition: Print Version: ISBN 9781464815218
    Language: English
    Keywords: Aufsatzsammlung
    URL: Volltext  (kostenfrei)
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  • 6
    UID:
    almahu_9949191560802882
    Format: 1 online resource (120 pages)
    Series Statement: International Development in Focus
    Content: This book describes the nature of public-private partnerships (PPPs) in the health sector in Vietnam. It defines health-related PPPs, describes their key characteristics, and develops a taxonomy of the different types of PPPs that exist in practice, illustrated by international examples. It also assesses the regulatory and institutional framework for the health PPP program in Vietnam, as well as financing and accountability mechanisms for PPPs at its national and subnational levels. It provides an overview of the PPP project pipeline in Vietnam and analyzes important issues in the health PPPs design, preparation, and implementation, using eight case studies involving projects in different phases of the project cycle. This book also examines barriers that have hampered the successful design and implementation of health care PPPs in Vietnam. These barriers may be broadly categorized as barriers in the PPP policy and regulatory framework, in the public sector, in the private sector, and in the financial sector. It proposes feasible and actionable recommendations so that the government can consider tackling the identified barriers and advance the successful design and implementation of health PPPs.
    Additional Edition: Print Version: ISBN 9781464815744
    Language: English
    URL: Volltext  (kostenfrei)
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  • 7
    UID:
    almafu_9958246557402883
    Format: 1 online resource (37 pages)
    Series Statement: Policy research working papers.
    Content: This paper looks at differential progress on the health Millennium Development Goals between the poor and better-off within countries. The findings are based on original analysis of 235 Demographic and Health Surveys and Multiple Indicator Cluster Surveys, spanning 64 developing countries over the period 1990-2011. Five health status indicators and seven intervention indicators are tracked for all the health Millennium Development Goals. In most countries, the poorest 40 percent have made faster progress than the richest 60 percent. On average, relative inequality in the Millennium Development Goal indicators has been falling. However, the opposite is true in a sizable minority of countries, especially on child health status indicators (40-50 percent in the cases of child malnutrition and mortality), and on some intervention indicators (almost 40 percent in the case of immunizations). Absolute inequality has been rising in a larger fraction of countries and in around one-quarter of countries, the poorest 40 percent have been slipping backward in absolute terms. Despite reductions in most countries, relative inequalities in the Millennium Development Goal health indicators are still appreciable, with the poor facing higher risks of malnutrition and death in childhood and lower odds of receiving key health interventions.
    Language: English
    URL: Volltext  (Deutschlandweit zugänglich)
    URL: Volltext  (kostenfrei)
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  • 8
    UID:
    almafu_9958143957202883
    Format: 1 online resource (71 pages)
    Series Statement: Policy research working papers.
    Content: This paper uses a common household survey instrument and a common set of imputation assumptions to estimate the pro-poorness of government health expenditure across 69 countries at all levels of income. On average, government health expenditure emerges as significantly pro-rich, but there is heterogeneity across countries: in the majority, government health expenditure is neither pro-rich nor pro-poor, while in a small minority it is pro-rich, and in an even smaller minority it is pro-poor. Government health expenditure on contracted private facilities emerges as significantly pro-rich for all types of care, and in almost all Asian countries government health expenditure overall is significantly pro-rich. The pro-poorness of government health expenditure at the country level is significantly and positively correlated with gross domestic product per capita and government health expenditure per capita, significantly and negatively correlated with the share of government facility revenues coming from user fees, and significantly and positively correlated with six measures of the quality of a country's governance; it is not, however, correlated with the size of the private sector nor with the degree to which the private sector delivers care disproportionately to the better-off. Because poorly-governed countries are underrepresented in the sample, government health expenditure is likely to be even more pro-rich in the world as a whole than it is in the countries in this study.
    Language: English
    URL: Volltext  (URL des Erstveröffentlichers)
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 9
    UID:
    b3kat_BV048267555
    Format: 1 Online-Ressource
    Series Statement: Other Health Study
    Content: The health equity and financial protection datasheets provide a picture of equity and financial protection in the health sectors of low- and middle-income countries. Topics covered include: inequalities in health outcomes, health behavior and health care utilization; benefit incidence analysis; financial protection; and the progressivity of health care financing. This report show how health outcomes, risky behaviors and health care utilization vary across asset (wealth) quintiles and periods. Benefit-incidence analysis (BIA) shows whether, and by how much, government health expenditure disproportionately benefits the poor the distribution of subsidies depends on the assumptions made to allocate subsidies to households. This reports whether overall health financing, as well as the individual sources of finance, is regressive (i.e. a poor household contributes a larger share of its resources than a rich one), progressive (i.e. a poor household contributes a smaller share of its resources than a rich one) or proportional
    Language: English
    URL: Volltext  (kostenfrei)
    URL: Volltext  (Deutschlandweit zugänglich)
    URL: Volltext  (Deutschlandweit zugänglich)
    URL: Volltext  (Deutschlandweit zugänglich)
    URL: Volltext  (Deutschlandweit zugänglich)
    URL: Volltext  (kostenfrei)
    URL: Volltext  (kostenfrei)
    URL: Volltext  (kostenfrei)
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  • 10
    UID:
    b3kat_BV048268438
    Format: 1 Online-Ressource
    Series Statement: Health, Nutrition and Population (HNP) Discussion Papers
    Content: In December 2012, the government of the Philippines passed the Sin Tax Law (RA 10351) which restructured and raised tobacco and alcohol taxes, while earmarking 85 percent of the incremental revenues for health. Of this 85 percent, 80 percent was intended to be used to provide free health insurance for poor and near-poor families through the National Health Insurance Program managed by PhilHealth, programs intended to speed progress of the health Millennium Development Goals, and programs to promote health awareness. The remaining 20 percent augments the financing of the Medical Assistance Program of the Department of Health (DOH), which is a hospital-based fund (in the name of mayors, congressmen, and DOH officials) that can be used at the discretion of the facility to cover the medical costs of those who cannot afford to pay, and also the DOH's Health Facilities Enhancement Program which allows the DOH to supplement the local governments' investments in health facilities. This reform was important from a health financing perspective.In November 2014, free health insurance coverage was also extended to the elderly. This paper assesses the extent to which the automatic enrollment of a large number of poor and elderly people into health insurance programs, as a result of the Sin Tax Law, has been associated with an increase in self-reported health insurance coverage, especially among the poorest quintiles and households living below the poverty line
    Language: English
    URL: Volltext  (kostenfrei)
    URL: Volltext  (Deutschlandweit zugänglich)
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