tailieunhanh - Community-based health insurance in developing countries: a study of its contribution to the performance of health financing systems

Long-term care providers are supported either locally, by the federal states, or by non-profit or private organisations. A supply contract (Versorgungsvertrag) is concluded between these institutions and the insurance funds. This contract is essential for ongoing home care or nursing home care in that it qualifies this form of support for the recognised LTC market. The supply contract regulates the type, contents, and extent of the general nursing benefits which a care institution must provide. It also defines the so-called care package (Leistungskomplexe). Nursing institutions must guarantee humane, dignified, and stimulating care, and must respect human rights. Frail. | Tropical Medicine and International Health volume 10 no 8 pp 799-811 august 2005 Community-based health insurance in developing countries a study of its contribution to the performance of health financing systems Guy Carrin1 Maria-Pia Waelkens2 and Bart Criel2 1 Department of Health Financing Expenditure and Resource Allocation World Health Organisation Geneva Switzerland 2 Department of Public Health Institute of Tropical Medicine Antwerp Belgium Summary We studied the potential of community-based health insurance CHI to contribute to the performance of health financing systems. The international empirical evidence is analysed on the basis of the three health financing subfunctions as outlined in the World Health Report 2000 revenue collection pooling of resources and purchasing of services. The evidence indicates that achievements of CHI in each of these subfunctions so far have been modest although many CHI schemes still are relatively young and would need more time to develop. We present an overview of the main factors influencing the performance of CHI on these financing subfunctions and discuss a set of proposals to increase CHI performance. The proposals pertain to the demand for and the supply of health care in the community to the technical managerial and institutional set-up of CHI and to the rational use of subsidies. keywords performance of financing health systems health financing community health insurance developing countries Introduction Health financing systems through general taxation or through the development of social health insurance are generally recognized to be powerful methods to achieve universal coverage with adequate financial protection for all against healthcare costs. These systems intend to respond to the goal of fairness in financing in that beneficiaries are asked to pay according to their means while guaranteeing them the right to health services according to need. In tax-funded systems the population contributes indirectly via .

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