Suchergebnisse

The implementation of social security on health insurance, is a manifestation of Article 28H and 34 of the 1945 Constitution in Indonesia. It is one of the social security guarantees stipulated in Article 19 paragraph (1) of the Law on the National Social Security System provided to participants based on the value of certain contributions or payments on health risks. However, there are differences concerning the obligation of participants on the type of health service to be obtained. Those unable to afford this service are grouped into participants that receive contribution assistance (PBI) paid by the Government. Others include wage recipients (PPU), such as public and private as well as independent employees, including non-wage recipients (PBPU). The existing differences in determining the contribution payment for participants lead to injustice. Therefore, this research aims to analyze the reasons associated with the inability of social justice for health insurance managed by the Healthcare and Social Security Agency (BPJS) to function optimally. The results showed that the functionalization of the social justice principle managed by BPJS requires changes to the provisions of health insurance. It also showed the process used to determine the group of PBPU and BPI participants and the number of contributions by investors and employers.

This paper contains a revenue prediction model that should be useful in planning and allocating budgets of the Ministries of Health

The Zimbabwean government has instigated various policies and strategies as part of e-government initiatives to provide members of the public with convenient access to health information and services. Efforts have been made to embrace ICTs in Zimbabwe's public health sector. The performance of health institutions in Zimbabwe however continues to deteriorate at a time when the use of ICTs in health is gaining momentum in Africa. This paper therefore seeks to assess the implementation of the E-health strategy revealing the current state of e-health or digital technology systems in Zimbabwe's public hospitals. The study adopted an exploratory research design. Participants in this study were selected using purposive sampling. Data were gathered through participant observations, in-depth interviews and documentary research. The study established that even though e-health is an indispensable tool in improving quality, timely and cost effective health care, its implementation in Zimbabwe has not been easy and it is still in its infancy stages. The study concluded that e-health is a reliable tool for promoting successful and effective public health service provision in Zimbabwe. The study therefore reflects and proposes elements necessary for the successful implementation of e-health in Zimbabwe's public health sector.

This paper provides an overview of the current sources of finance for health services in South Africa and the complex financial flows within the public and private health sectors. In addition, aggregate public and private sector health care expenditure is quantified, based on routinely published data sources. The brief analysis indicates that health care expenditure has increased more rapidly in the private sector than in the public sector in the past decade, and private sector expenditure now exceeds that in the public sector. This trend reflects the present government policy of reducing its responsibility for health service financing. (DÜI-Hff)

Cover -- Title -- Copyright -- Contents -- Tables, Figures, and Boxes -- Foreword -- Preface -- Acknowledgments -- Abbreviations -- Chapter 1 Introduction -- I Overview -- II Provincial Socioeconomic and Health Sector Context -- III Purpose and Scope -- IV Methodology -- Chapter 2 Health Governance -- I Overview -- II Achievements -- III Challenges -- IV Recommendations -- Chapter 3 Health Infrastructure -- I Overview -- II Achievements -- III Current Status -- IV Challenges -- V Recommendations -- Chapter 4 Health Financing -- I Overview -- II Achievements -- III Current Status and Challenges -- IV Recommendations -- References -- Appendixes -- 1 Case Study on Hospital Contracting Experience in Khyber Pakhtunkhwa -- 2 Key Elements of a Strong Contract -- 3 Methodology for Modeling Demand for Health Care -- 4 Continuous Quality Improvement Description and Good Practice Examples of Standard Operating Procedures for Medical Care -- 5 Financing Sources by Financing Agents, FY2016 -- 6 Overview of Population Segments Receiving Financial Coverage for Health -- 7 Social Health Protection Initiative: Sehat Sahulat Program -- 8 Actuarial Projections of Supply and Demand-Side Interventions in the Khyber Pakhtunkhwa Health Sector.

Background: Corruption is the abuse or complicity in abuse, of public or private position, power or authority to benefit oneself, a group, an organisation or others close to oneself; where the benefits may be financial, material or non-material. It is wide-spread in the health sector and represents a major problem. Objectives: Our primary objective was to systematically summarise empirical evidence of the effects of strategies to reduce corruption in the health sector. Our secondary objective was to describe the range of strategies that have been tried and to guide future evaluations of promising strategies for which there is insufficient evidence. Search methods: We searched 14 electronic databases up to January 2014, including: CENTRAL; MEDLINE; EMBASE; sociological, economic, political and other health databases; Human Resources Abstracts up to November 2010; Euroethics up to August 2015; and PubMed alerts from January 2014 to June 2016. We searched another 23 websites and online databases for grey literature up to August 2015, including the World Bank, the International Monetary Fund, the U4 Anti-Corruption Resource Centre, Transparency International, healthcare anti-fraud association websites and trial registries. We conducted citation searches in Science Citation Index and Google Scholar, and searched PubMed for related articles up to August 2015. We contacted corruption researchers in December 2015, and screened reference lists of articles up to May 2016. Selection criteria: For the primary analysis, we included randomised trials, non-randomised trials, interrupted time series studies and controlled before-after studies that evaluated the effects of an intervention to reduce corruption in the health sector. For the secondary analysis, we included case studies that clearly described an intervention to reduce corruption in the health sector, addressed either our primary or secondary objective, and stated the methods that the study authors used to collect and analyse data. Data collection and analysis: One review author extracted data from the included studies and a second review author checked the extracted data against the reports of the included studies. We undertook a structured synthesis of the findings. We constructed a results table and 'Summaries of findings' tables. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess the certainty of the evidence. Main results: No studies met the inclusion criteria of the primary analysis. We included nine studies that met the inclusion criteria for the secondary analysis. One study found that a package of interventions coordinated by the US Department of Health and Human Services and Department of Justice recovered a large amount of money and resulted in hundreds of new cases and convictions each year (high certainty of the evidence). Another study from the USA found that establishment of an independent agency to investigate and enforce efforts against overbilling might lead to a small reduction in overbilling, but the certainty of this evidence was very low. A third study from India suggested that the impacts of coordinated efforts to reduce corruption through increased detection and enforcement are dependent on continued political support and that they can be limited by a dysfunctional judicial system (very low certainty of the evidence). One study in South Korea and two in the USA evaluated increased efforts to investigate and punish corruption in clinics and hospitals without establishing an independent agency to coordinate these efforts. It is unclear whether these were effective because the evidence is of very low certainty. One study from Kyrgyzstan suggested that increased transparency and accountability for co-payments together with reduction of incentives for demanding informal payments may reduce informal payments (low certainty of the evidence). One study from Germany suggested that guidelines that prohibit hospital doctors from accepting any form of benefits from the pharmaceutical industry may improve doctors' attitudes about the influence of pharmaceutical companies on their choice of medicines (low certainty of the evidence). A study in the USA, evaluated the effects of introducing a law that required pharmaceutical companies to report the gifts they gave to healthcare workers. Another study in the USA evaluated the effects of a variety of internal control mechanisms used by community health centres to stop corruption. The effects of these strategies is unclear because the evidence was of very low certainty. Authors' conclusions: There is a paucity of evidence regarding how best to reduce corruption. Promising interventions include improvements in the detection and punishment of corruption, especially efforts that are coordinated by an independent agency. Other promising interventions include guidelines that prohibit doctors from accepting benefits from the pharmaceutical industry, internal control practices in community health centres, and increased transparency and accountability for co-payments combined with reduced incentives for informal payments. The extent to which increased transparency alone reduces corruption is uncertain. There is a need to monitor and evaluate the impacts of all interventions to reduce corruption, including their potential adverse effects.