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  • 1
    Language: English
    Pages: Online-Ressource (33 p)
    Edition: 2013 World Bank eLibrary
    Parallel Title: Nguyen, Ha Thi Hong Getting Incentives Right
    Abstract: With the movement toward universal health coverage gaining momentum, the global health research community has made significant efforts to advance knowledge about the impact of various schemes to expand population coverage. The impacts on efficiency, quality, and gaps in service utilization of reforms to provider payment methods are less well studied and understood. The current paper contributes to this limited knowledge by evaluating the impact of a shift by Vietnam's social health insurance agency from reimbursing hospitals on a fee-for-service basis to making a capitation payment to the district hospital where the enrollee lives. The analysis uses panel data on hospitals over the period 2005-2011 and multiple cross-section data sets from the Vietnam Household Living Standards Surveys to estimate impacts on efficiency, quality, and equity. The paper finds that capitation increases hospitals' efficiency, as measured by recurrent expenditure and drug expenditure per case, but has no effect on surgery complication rates or in-hospital deaths. In response to the shift to capitation, hospitals scaled down service provision to the insured and increased provision to the uninsured (who continue to pay out-of-pocket on a fee-for-service basis). The study points to the need to anticipate the intended and unintended effects of any payment reform and the trade-offs among policy objectives
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 2
    Language: English
    Pages: 1 Online-Ressource
    Series Statement: Other Health Study
    Keywords: Air Pollution ; Alcohol and Substance Abuse ; Disease Control and Prevention ; Economic Burden ; Health Burden ; Health, Nutrition and Population ; NCDS ; Policies and Regulations ; Sugar-Sweetened Beverages ; Tobacco and Alcohol ; Tobacco Use and Control
    Abstract: This report, which aims to raise awareness, identify gaps, and inform policies, is the first comprehensive report on NCDs in Kosovo. Unlike available studies, the present work explores multiple aspects of NCDs, including their burden on health outcomes, risk factors, management, economic burden, and policies introduced to protect the population from these conditions. The report's findings are based on data from existing literature, official documents such as laws, regulations, and protocols, secondary data analysis, and interviews with key informants. The report presents comparisons with available data from the Western Balkans (Albania, Bosnia and Herzegovina [BiH], Montenegro, North Macedonia, and Serbia), aspirational (former socialist, small European Union member states such as Croatia, Estonia, Latvia, Lithuania, and Slovenia) and structural peers (Albania, Armenia, Moldova, North Macedonia, and Kyrgyz) to contextualize the findings. The report concludes by providing recommendations to reduce the burden of NCDs in Kosovo to protect the human capital of current and future generations
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  • 3
    Language: English
    Pages: Online-Ressource (20 p)
    Edition: 2014 World Bank eLibrary
    Parallel Title: Wagstaff, Adam Encouraging Health Insurance for the Informal Sector
    Abstract: Subsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. This paper reports the results of a cluster randomized control trial in which 3,000 households in 20 communes in Vietnam were randomly assigned at baseline to a control group or one of three treatments: an information leaflet about Vietnam's government-run scheme and the benefits of health insurance; a voucher entitling eligible household members to 25 percent off their annual premium; and both. The four groups were balanced at baseline. In the control group, 6.3 percent (82/1296) of individuals were enrolled in the endline, compared with 6.3 percent (79/1257), 7.2 percent (96/1327), and 7.0 percent (87/1245) in the information, subsidy, and combined intervention groups; the adjusted odds ratios were 0.94, 1.12, and 1.15, respectively. Only among those reporting poor health were any significant intervention effects found, and only for the combined intervention: an enrollment rate of 16.3 percent (33/202) compared with 8.3 percent (18/218) in the control group, and an adjusted odds ratio of 2.50. The results suggest limited opportunities to raise voluntary health insurance enrollment through information campaigns and subsidies, and that these interventions exacerbate adverse selection
    URL: Volltext  (Deutschlandweit zugänglich)
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