شناسایی عناصر اصلی سیستم پرداخت کننده واحد؛ مطالعهای تطبیقی
Publish Year: 1398
نوع سند: مقاله ژورنالی
زبان: English
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شناسه ملی سند علمی:
JR_EBHPME-3-2_008
تاریخ نمایه سازی: 20 دی 1399
Abstract:
Background: Progress towards universal coverage requires adequate capital in health sector. Investing and optimal allocation of resources in this sector will contribute to the development and reduction of poverty in countries in order to achieve the goals of health system. Therefore, the more people contribute to risk sharing, we have lower financial risks in facing the issue. The single payer system as a public health coverage model seeks to expand the insurance coverage scope at community level. The present study aimed to identify the main elements of S-PS to conduct a comparative study.
Methods: A comparative study was conducted to describe the fundamental of financing and the provision of services in selected countries - Germany, Thailand, Turkey, and Colombia, as well as to achieve the main elements of S-PS. In addition, the health system of Iran has been studied. The basis for selection of countries was health system Garden typology. The main criteria for selection or rejection of studies were the separation of health services provider from financial functions; has allowed a single department to purchasing process.
Results: single payer system in two functions of health system, namely, financing and providing health care; consolidation resources (reducing fragmentation by creating a single pooled fund and achieve massive purchase of health care through the insurance agent as single purchaser) and ensuring community health (delivery of services by the network of providers represented by Health Promotion Organization) represents 12 main organizational elements.
Conclusion: the multiple insurers and payers of health care in Iran are both inequity and ineffective. And its integration is not a simple task. Iranian financing policies should aimed to achieving universal health coverage by creating greater risk pooling and becoming aware of the important tasks of insurance system; take advantage of the strength in numbers, setting the principles of cross-subsidy and preventing adverse reaction. It is important not to put together a long-term, coherent plan to reach the S-PS.
Keywords:
consolidation , Health Insurance funds , health care reform , multiple pools , Single Payer System , سیستم پرداخت کننده واحد , نظامهای سلامت , نظامهای بیمه سلامنت , تجمیع منابع بیمه ای , اصلاحات
Authors
Ali Aboutorabi
School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
Saman Ghasempour
Health Management and Economics Research centre, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
Behzad Najafi
School of Health Management and Information Sciences, Tabriz University of Medical Sciences, Tehran, Iran
Sirous Panahi
School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran