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Can reductions in informal payments be sustained?: Evidence from Kyrgyzstan, 2001–2013 / Jakab, Melitta;Akkazieva, Baktygul;Kutzin, Joseph

Tác giả : Jakab, Melitta;Akkazieva, Baktygul;Kutzin, Joseph

Nhà xuất bản : World Health Organization. Regional Office for Europe

Năm xuất bản : 2016

Chủ đề : 1. Financing, Personal. 2. Health Care Reform. 3. Health Expenditures. 4. Kyrgyzstan. 5. Universal Health Insurance. 6. Technical documents.

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48 p. Kyrgyzstan demonstrated impressive results in reducing informal payments in its health system between 2001 and 2006, particularly for medicines, medical supplies and food. This was achieved by introducing reforms to reduce inefficiencies in the health system, by strengthening primary health care, restructuring the hospital network and channelling the savings to medicines and supplies. The health financing reforms facilitated this transformation of service delivery by introducing a single-payer system, with progressive centralization of funds, pooling and introduction of population and output-based provider payment mechanisms. The findings demonstrate that policies matter and that the right mix of policies can contribute to reducing informal payments. Our results also show, however, that Kyrgyzstan could not sustain these gains in the longer run, as informal payments began to increase again after 2006, offsetting previous gains. This reversal was driven to a great extent by informal payments to medical personnel, despite a sizeable salary increase introduced in 2011, and to a lesser extent by informal payments for medicines and supplies. A number of factors contributed to the reversal of the positive trends in informal payments after 2006, including the overextended State-guaranteed benefit package, the low salaries and poor working conditions of health workers, outdated purchasing mechanisms that fuel hospitalizations, rigidity in public finance, remaining inefficiency in service delivery, inefficient public procurement of medicines and supplies and the absence of provider performance monitoring. The persistence of informal payments remains a problem because they continue to impose an unpredictable financial burden on patients and undermine the credibility of the State-guaranteed benefit package. There is no magic bullet for further reducing informal payments in the Kyrgyz health system. A comprehensive, multi-pronged approach that addresses the causes simultaneously could succeed if public funding is maintained at current levels.

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Thư viện	Ký hiệu xếp giá	Dữ liệu nguồn
Tổ chức y tế thế giới		https://iris.who.int/handle/10665/369410

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041	__	$aen
100	__	$aJakab, Melitta
245	__	$aCan reductions in informal payments be sustained?: Evidence from Kyrgyzstan, 2001–2013 /$cJakab, Melitta;Akkazieva, Baktygul;Kutzin, Joseph
260	__	$bWorld Health Organization. Regional Office for Europe ,$c2016
520	__	$a48 p.
520	__	$aKyrgyzstan demonstrated impressive results in reducing informal payments in its health system between 2001 and 2006, particularly for medicines, medical supplies and food. This was achieved by introducing reforms to reduce inefficiencies in the health system, by strengthening primary health care, restructuring the hospital network and channelling the savings to medicines and supplies. The health financing reforms facilitated this transformation of service delivery by introducing a single-payer system, with progressive centralization of funds, pooling and introduction of population and output-based provider payment mechanisms. The findings demonstrate that policies matter and that the right mix of policies can contribute to reducing informal payments. Our results also show, however, that Kyrgyzstan could not sustain these gains in the longer run, as informal payments began to increase again after 2006, offsetting previous gains. This reversal was driven to a great extent by informal payments to medical personnel, despite a sizeable salary increase introduced in 2011, and to a lesser extent by informal payments for medicines and supplies. A number of factors contributed to the reversal of the positive trends in informal payments after 2006, including the overextended State-guaranteed benefit package, the low salaries and poor working conditions of health workers, outdated purchasing mechanisms that fuel hospitalizations, rigidity in public finance, remaining inefficiency in service delivery, inefficient public procurement of medicines and supplies and the absence of provider performance monitoring. The persistence of informal payments remains a problem because they continue to impose an unpredictable financial burden on patients and undermine the credibility of the State-guaranteed benefit package. There is no magic bullet for further reducing informal payments in the Kyrgyz health system. A comprehensive, multi-pronged approach that addresses the causes simultaneously could succeed if public funding is maintained at current levels.
650	_2	$aFinancing, Personal
650	_2	$aHealth Expenditures
650	_2	$aHealth Care Reform
650	_2	$aUniversal Health Insurance
650	_2	$aKyrgyzstan
655	__	$aTechnical documents
700	__	$aAkkazieva, Baktygul
700	__	$aKutzin, Joseph
856	__	$uhttps://iris.who.int/handle/10665/369410
900		1
907		https://iris.who.int/bitstream/handle/10665/369410/WHO-EURO-2016-6552-46318-67003-eng.pdf.jpg?sequence=4&isAllowed=y
925		G
926		0
927		SH

Can reductions in informal payments be sustained?: Evidence from Kyrgyzstan, 2001–2013 / Jakab, Melitta;Akkazieva, Baktygul;Kutzin, Joseph

Thông tin dữ liệu nguồn

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Долгосрочные тенденции финансового бремени в ходе обращения за медицинскими услугами в Кыргызстане, 2000 – 2014 гг. / Akkazieva, Baktygul;Jakab, Melitta;Temirov, Adyl

Long-term trends in the financial burden of health care seeking in Kyrgyzstan, 2000–2014 / Akkazieva, Baktygul;Jakab, Melitta;Temirov, Adyl

How does the introduction of patient co-payments for selected health services affect formal and informal out-of-pocket payments and utilization?: Evidence from Armenia / Akkazieva, Baktygul;Jowett, Matthew

Можно ли обеспечить устойчивость снижения неформальных платежей?: Результаты из Кыргызстана: 2001–2013 гг. / Jakab, Melitta;Akkazieva, Baktygul;Kutzin, Joseph

Health systems respond to noncommunicable diseases: compendium of good practices / Jakab, Melitta;Borgermans, Liesbeth;Cerezo Cerezo, José;Farrington, Jill

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