scholarly journals The Influence of Israel Health Insurance Law on the Negev Bedouin Population — A Survey Study

2006 ◽  
Vol 6 ◽  
pp. 81-95 ◽  
Author(s):  
Mohammed Morad ◽  
Shifra Shvarts ◽  
Joav Merrick ◽  
Jeffrey Borkan

The extension of universal health service insurance to national populations is a relatively new phenomenon. Since 1995, the Israeli National Health Insurance Law (NHIL) has provided universal health services to every resident, but the effect of this law on health and health services among minorities has not been examined sufficiently. The goals of this study were to track some of the first changes engendered by the NHIL among the Negev Bedouin Arabs to examine the effects of universal health care services. Methods included analysis of historical and health policy documents, three field appraisals of health care services (1994, 1995, 1999), a region-wide interview survey of Negev Bedouins (1997), and key informant interviews. For the interview survey, a sample of 515 households was chosen from different Bedouin localities representing major sedentarization stages. Results showed that prior to the NHIL, a substantial proportion of the Negev Bedouins were uninsured with limited, locally available health service. Since 1995, health services, particularly primary care clinics and health manpower, have dramatically expanded. The initial expansion appears to have been a marketing ploy, but real improvements have occurred. There was a high level of health service utilization among the Bedouins in the Negev, especially private medical services, hospitals, and night ambulatory medical services. The NHIL brought change to the structure of health services in Israel, namely the institution of a national health system based on proportional allocation of resources (based on size and age) and open competition in the provision of quality health care. The expansion of the pool of potential members engendered by the new universal coverage had profound effects on the Health Funds' attitudes towards Negev Bedouins. In addition, real consumer choice was introduced for the first time. Although all the health care needs of this rapidly growing population have yet to be met fully, the assurances under the Law and the new level of competition promise a higher level of service in the future.

2021 ◽  
pp. 141-151
Author(s):  
Paweł Lipowski

The aim of this study is to identify the legal characteristics of contracts for the health care services provided by a public payer, i.e. the National Health Fund (NFZ) as part of treatment covered by universal health insurance, as compared to those provided by the health care providers with public or private legal status. This issue is discussed in relation to the legal conditions for the treatment of patients on a commercial basis in those institutions (private or public) which have contracts for the provision of healthcare services under the general health insurance (so-called contracts). The discussion is presented based on author’s own observations, resulting both from his scientific studies in the field of medical law and his work in various entities operating in the health care system.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Arrivillaga

Abstract Background Colombia has an insurance-based, private and public health care system, with the intermediation of health insurance agencies that control the resources. At present, the Universal Health Coverage (UHC) is around 97%. However, there is wide scientific evidence that criticizes the structure and operation of the system due to the persistent differences between the UHC indicator and real accessibility to health services. This study aimed to analyze the concept of accessibility of health services in order to design and validate alternatives instruments for its assessment beyond UHC. Methods A mixed methods approach with concurrent design in three phases was conducted between 2014 and 2017: 1) systematic review of literature and documentary research; 2) design, content validation with experts and pilot test of instruments to assess health care accessibility and 3) definition of a route to assess accessibility. Results The reviewed literature revealed five conceptual logics to define accessibility: decent minimum of health care, health care market, factors and multicausality, needs and, social justice and human right to health. A Household Survey on Accessibility to Health Care Services and a Health Care Services Availability Questionnaire was designed and validated with experts and pilot test in representative samples of households and care centers in three cities in Colombia was conducted. Those instruments were designed under the conceptual logic of human right to health. Finally, an alternative route to assess accessibility in Colombia was proposed. Conclusions The route for assessing accessibility with primary data, territorial approach and without intermediation of health insurance agencies allow obtaining an overview of the real situation beyond the UHC indicator. The instruments included in this assessing process can be useful to monitor progress in guaranteeing the human right to health, declared in Colombia and other countries. Key messages The UHC indicator is not enough to assess real accessibility to health services. This study presents an alternative route and two validated instruments for its assessment with primary data and territory-based approach, applicable to countries with public-private health systems.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Abubakar Yusuf ◽  
Abubakar M. Jibo ◽  
Sanusi Abubakar ◽  
Bukar A. Grema ◽  
Auwal U. Gajida ◽  
...  

The National Health Insurance Scheme (NHIS) aims at universal health coverage through access to high-quality health-care to all enrolees. To achieve this goal, it is necessary to incorporate feedbacks from periodic patient-surveys into service improvement plans. This study therefore, assessed satisfaction and utilization of health-care services by enrolees of a Nigerian tertiary hospital. This was a crosssectional study of 399 respondents randomly selected from enrolees attending the NHIS-clinic of Aminu Kano Teaching Hospital, Kano. Using an intervieweradministered questionnaire, it assessed their sociodemographics, medical history, number of and reason for clinic visits, satisfaction with- access to care, patient-provider relationships and hospital facilities/environment. Respondents’ mean age was 38.3 ± 9.2 years and females accounted for 55.9% of respondents. Most respondents (60.4%, 69.8%, 96.0%) were satisfied with the ease of accessing care, waiting-time and hospital facilities/environment respectively. Most respondents (94.8%, 81.1%, 73.3%, 74.5%, 83.1%, 91.1%) were satisfied with their relationship with physicians, nurses, laboratory staff, pharmacists, record officers and other hospital-staff respectively. Overall, 80.5% of respondents were satisfied with the hospital’s services. All respondents had visited the clinic at least once in the preceding 12-weeks. Although 49.1% visited for non-communicable diseases, more respondents who were for antenatal-care (followed by non-communicable and communicable diseases) had had ≥ 2 clinic visits (c2 =15.5%, df=2, P=0.0001). This study observed a high utilization of and overallsatisfaction with the hospital’s services; however, there is a need for service improvement plans to address the challenges of patient access to care and waitingtime.


Author(s):  
Minh Nguyen Thi ◽  
Phuong Hoang Bich ◽  
Thao Nguyen Thi

The Vietnam Health Insurance Law in 2008 promulgated universal health care by 2014. To build up a sound and sustainable health insurance system towards this goal, we need to account for the effect of asymmetric information on the use of the health care services, namely moral hazards and adverse selection. This paper uses distinc- tive features of Vietnam's health insurance system to separately estimate the effect of each type. Our results show that the effect of asymmetric information is quite severe and prevalent for old people, and is insignificant for young people. The results can be used for the construction of health insurance policies for Vietnam.


2019 ◽  
Vol 43 (3) ◽  
pp. 314 ◽  
Author(s):  
Kylie Gwynne ◽  
Thomas Jeffries Jr ◽  
Michelle Lincoln

Objective The aim of the present systematic review was to examine the enablers for effective health service delivery for Aboriginal Australians. Methods This systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Papers were included if they had data related to health services for Australian Aboriginal people and were published between 2000 and 2015. The 21 papers that met the inclusion criteria were assessed using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. Seven papers were subsequently excluded due to weak methodological approaches. Results There were two findings in the present study: (1) that Aboriginal people fare worse than non-Aboriginal people when accessing usual healthcare services; and (2) there are five enablers for effective health care services for Australian Aboriginal people: cultural competence, participation rates, organisational, clinical governance and compliance, and availability of services. Conclusions Health services for Australian Aboriginal people must be tailored and implementation of the five enablers is likely to affect the effectiveness of health services for Aboriginal people. The findings of the present study have significant implications in directing the future design, funding, delivery and evaluation of health care services for Aboriginal Australians. What is known about the topic? There is significant evidence about poor health outcomes and the 10-year gap in life expectancy between Aboriginal and non-Aboriginal people, and limited evidence about improving health service efficacy. What does this paper add? This systematic review found that with usual health care delivery, Aboriginal people experience worse health outcomes. This paper identifies five strategies in the literature that improve the effectiveness of health care services intended for Aboriginal people. What are the implications for practitioners? Aboriginal people fare worse in both experience and outcomes when they access usual care services. Health services intended for Aboriginal people should be tailored using the five enablers to provide timely, culturally safe and high-quality care.


1992 ◽  
Vol 5 (4) ◽  
pp. 48-53 ◽  
Author(s):  
Jeffrey L. Weatherill

This paper received the 1992 Agnew Peckham Literary Prize of the Canadian College of Health Service Executives in recognition of excellence in content and presentation of ideas related to a current issue in the management of health services.


1995 ◽  
Vol 25 (2) ◽  
pp. 271-282 ◽  
Author(s):  
Jack Reamy

New Brunswick moved swiftly in 1992 to regionalize hospital and physician services along with the reform and expansion of other health care services. The dissolution of 51 hospital and community health services center boards and the establishment of eight region hospital corporations to oversee services in the seven health regions set the tone for regionalization in the province. The plan provides the flexibility to meet specific regional needs. The initial regionalization of hospital services was followed by the determination of the appropriate number, mix, and distribution of physician resources for each region, also to be managed by the region hospital corporation. The provincial government's central role not only guides the regions, but also uses incentives and disincentives to ensure that regional goals are met. While regionalization is not new and some components of the New Brunswick plan have been used elsewhere, the effort offers an integrated model for the regionalization of hospital and physician services, with the expansion of complementary services.


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