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  • 1
    Online Resource
    Online Resource
    Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam (2013)
    Washington, D.C : The World Bank
    Details
    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
    DOI: 10.1596/1813-9450-6709
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 2
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    Online Resource
    Toward a More Pro-Poor and Explicit Health Benefit Package in the Kyrgyz Republic : A Critical Review of the State Guaranteed Benefit Package and Options for Its Revision (2019)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource
    Series Statement: World Bank E-Library Archive
    Series Statement: Health, Nutrition and Population (HNP) Discussion Papers
    Abstract: The Kyrgyz Republic has made significant steps in reforming the health system through successive National Health Programs implemented over the last 20 years. One of the major achievements of such reforms was the establishment of a single-payer national health insurance and a basic benefit package. The State Guaranteed Benefit Package (SGBP) provides free basic health services at the primary care level for the whole population, and inpatient care with nominal copayments or no fee for certain groups. Even though the principles of the SGBP contain elements of international good practice, the SGBP has hardly changed since it was established. At the same time, many changes have taken place within and outside the health system, exerting mounting pressure for the SGBP to adapt to the new disease burden and meet the population's expectations within the context of budget constraints. The current paper provides a critical assessment of the Kyrgyz Republic's basic health benefit package. It reveals a number of issues in the actual benefits delivered to the population as opposed to the generous promise of the statutory package. Some important limitations include lack of clarity, persistent funding gap, the large number of fee exemption categories given the resource constraints, and at the same time lack of an effective mechanism to protect the poor. Most importantly, there is no systematic arrangement in place to ensure a regular evidence-based process to revise the benefit package. The paper proposes several measures that could guide the process of SGBP revision, taking into account the particular Kyrgyz context and building on international experiences. It is expected that information from the paper will be useful not only for Kyrgyz stakeholders, but also for other countries in making the benefit package an effective instrument for achieving universal health coverage
    DOI: 10.1596/33096
    URL: Deutschlandweit zugänglich
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    MPI Ethno. Forsch.
  • 3
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    Online Resource
    Improving Grassroots Service Delivery Using Results-Based Financing in Vietnam : An Assessment of the Nghe An Pilot (2018)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource
    Series Statement: World Bank E-Library Archive
    Series Statement: Health, Nutrition and Population (HNP) Discussion Papers
    Abstract: Over the last decade, results-based financing (RBF) health programs have been implemented in several countries at different levels of income. Due to its requirement of rigorous verification of results as a condition for financing, as well as a number of accompanying measures to help achieve the results, RBF has a promise of value for money. RBF's potential for improving the performance of the service delivery system has led the government of Vietnam to undertake a pilot of RBF in the Nghe An province as part of a World Bank funded operation. The main objective of the pilot was to experiment an RBF approach in the Vietnam context, where public sector providers have been receiving budget allocation based on inputs rather than performance. A secondary objective was to test the effects of RBF in improving quality of care at the grassroots level and in addressing the challenges of emerging noncommunicable diseases. The intervention included quality improvement at the district level and both quality and quantity of services at commune health station
    DOI: 10.1596/30476
    URL: Deutschlandweit zugänglich
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  • 4
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    Online Resource
    Protecting Human Capital Through Shocks and Crises : How lessons learned from the COVID-19 response across Eastern Europe and the South Caucasus can be used to build better and more resilient human development systems (2023)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource
    Series Statement: Social Analysis
    Keywords: COVID-19 ; Disease Control and Prevention ; ECA ; Education ; Education Reform and Management ; Health and Education ; Health, Nutrition and Population ; Human Capital ; Resilience ; Social Protections and Assistance ; Social Protections and Labor
    Abstract: Risk and uncertainty are on the rise, and countries across Europe and Central Asia (ECA) are not immune from it. The region is being hit by crises, conflicts, and continued uncertainty that are negatively affecting people's livelihoods in the short term and prosperity in the long term. Then COVID-19 hit, inflicting massive harm on people's wellbeing, livelihoods, and human capital. Lockdowns prevented people from working, school closures prevented students from learning, and overwhelmed hospitals had to defer important treatments. This report explores how to strengthen the resilience of health, education, and social protection systems to better protect people's human capital from the long-term effects of recurrent shocks and crises
    DOI: 10.1596/39716
    URL: Deutschlandweit zugänglich
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  • 5
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    Online Resource
    Advancing Health Financing Reforms Toward Universal Health Coverage in Kosovo (2023)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource
    Series Statement: 2109
    Keywords: Gender and Economics ; Gender and Education ; Gender and Health ; Gender and Law ; Gender Monitoring and Evaluation ; Health Financing ; Health, Nutrition and Population ; Social Programs ; Social Protections and Labor ; UHC ; Universal Health Coverage
    Abstract: The objective of this paper is to facilitate common understanding of the health financing situation in Kosovo, to serve as a basis for reaching a consensus on the way forward. The issue is motivated by a basic framework of health financing functions and how they contribute to UHC goals. Global good practices and examples from peer countries are presented in the Annex to providecomparisons with the situation in Kosovo. The paper describes the status of health financing and its implications for UHC. A long-term vision for health financing is presented and recommendations for possible short and medium term (3-5 years) policy priorities are provided based on the current situation and desirable trajectory. The exclusive focus on health financing is deliberate although otherimportant health system functions, such as service delivery and governance, will need to move in parallel for health financing reforms to achieve their intended outcomes
    DOI: 10.1596/40459
    URL: Deutschlandweit zugänglich
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  • 6
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    Online Resource
    Serbia - Toward a More Effective, Efficient, Equitable and Resilient Health System (2023)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource
    Series Statement: Country Environmental Analysis
    Keywords: Coverage ; Equitable ; Financing ; Health Economics and Finance ; Health System ; Health, Nutrition and Population ; Resilient
    Abstract: The health system in Serbia faces significant challenges arising from a long-term demographic trend and the recent shock caused by the COVID-19 pandemic. Serbia's population is aging at a rapid pace, and the share of the population aged 65 and above almost doubled -from 9.6 percent to 18.7 percent-between 1990 and 2019. This, coupled with high prevalence of unhealthy lifestyle factors, such as smoking, heavy drinking, and high consumption of fatty and sugary diet, has contributed to a rapidly rising burden of noncommunicable diseases (NCDs). Addressing NCDs exerts significant financial pressure on the health system that has been further squeezed after more than two years of dealing with COVID-19. This is all happening in a context where the economic contraction that began in 2020 after the advent of COVID-19 pandemic and compounded with the war in Ukraine has adversely affected the country's capacity to pay for health. The health system also has a challenge to meet population expectations, which have become more demanding after decades of strong economic growth
    DOI: 10.1596/39501
    URL: lizenzpflichtig
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  • 7
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    Online Resource
    The State of Noncommunicable Diseases in Kosovo (2023)
    Washington, D.C : The World Bank
    Details
    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
    DOI: 10.1596/39935
    URL: Deutschlandweit zugänglich
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  • 8
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    Online Resource
    Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial (2014)
    Washington, D.C : The World Bank
    Details
    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
    DOI: 10.1596/1813-9450-6910
    URL: Volltext  (Deutschlandweit zugänglich)
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  • 9
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    Online Resource
    Assessing Quality of Care in the Kyrgyz Republic : Quality Gaps and Way Forward (2020)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource
    Series Statement: World Bank E-Library Archive
    Series Statement: Health, Nutrition and Population (HNP) Discussion Papers
    Abstract: Systematic assessments of the quality of care provide a platform for taking stock of achievements, identifying gaps, and having an informed discourse on the way forward. However, data-driven comprehensive assessments of the state of quality in the Kyrgyz Republic are lacking, despite much anecdotal evidence on poor quality of care. This report will be the first attempt at bringing together different datasets and sources of information to provide a comprehensive data-driven view of the state of quality in the country, with international benchmarking of the Kyrgyz data as and when appropriate. This report will describe the socioeconomic context in the country with a focus on health financing and outcomes in its first chapter. In the second chapter, the current state of quality in the Kyrgyz Republic will be evaluated using the quality measurement framework proposed by Donabedian. Findings from the assessment will inform key conclusions and policy recommendations in the final chapter of the report
    DOI: 10.1596/34376
    URL: Deutschlandweit zugänglich
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  • 10
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    Online Resource
    COVID-19 Vaccine Acceptance Among Marginalized Populations in Kosovo : Insight from a Qualitative Study (2022)
    Washington, D.C : The World Bank
    Details
    Language: English
    Pages: 1 Online-Ressource
    Series Statement: Health, Nutrition and Population (HNP) Discussion Papers
    Keywords: Health, Nutrition and Population ; Immunizations
    Abstract: Kosovo has fully vaccinated 45.5 percent of the population, below what is needed to slow the spread of COVID-19. The Roma, Ashkali, and Egyptian communities, as marginalized ethnic groups, have been identified as high risk for acquiring COVID-19 and for lower acceptance of vaccines. Factors associated with vaccine acceptance are examined in this qualitative study among Roma, Ashkali, and Egyptian community members and representatives from civil society, community leaders, health care providers, and government working directly within these communities. Using a social-ecological model, intrapersonal, interpersonal, community, and structural factors influencing vaccine acceptance were identified. Intrapersonal-level factors centered on fear of side effects and doubt about vaccine safety and effectiveness, and lack of trust of health care providers; at the interpersonal level, male head of households decided for the entire family whether to receive the vaccine; in the social context at the community level, exposure to prolific misinformation on social media, television news, and paper pamphlets distributed in study communities created fear, doubt, and anxiety about vaccines, and stereotypes about the strong immune systems of ethnic minority groups reinforced beliefs about the communities low susceptibility to COVID-19; and structural-level barriers included the requirement for identification documents, and a buildup of doubt about motivations of the vaccinators created by massive vaccine-promotion efforts and police harassment in implementing curfew, and other protective measures targeting ethnic minority communities. Implications of these findings highlight a need for a segmented approach in designing subgroup-specific and multicomponent interventions to promote vaccine acceptance. Strategies include training local opinion leaders in door-to-door awareness raising, directly addressing misinformation, and distributing vouchers to be exchanged for incentives after vaccination; using social media where respected health care providers and community members post videos promoting vaccination; and removing or providing an alternative to identification requirements
    DOI: 10.1596/38303
    URL: lizenzpflichtig
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    MPI Ethno. Forsch.
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