Health Insurance Portability and Accountability Act (HIPAA) legislation and its implication on speech privacy design in health care facilities

2005 ◽  
Vol 118 (3) ◽  
pp. 1956-1956
Author(s):  
Gregory C. Tocci ◽  
Christopher A. Storch
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Facilities ◽  
Care Facilities ◽  
Health Insurance Portability

Kajian Kebijakan Jaminan Kesehatan Masyarakat

2010 ◽  
Vol 13 (2) ◽  
pp. 98-104
Author(s):  
Imami Nur Rachmawati
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Public Service ◽  
Living Environment ◽  
Health Care Facilities ◽  
The State ◽  
Human Right ◽  
Care Facilities ◽  
Community Health Insurance ◽  
Good Living

AbstrakKesehatan adalah hak asasi manusia. Sesuai dengan Pancasila dan amanat UUD 1945 yaitu pasal 28H ayat (1) yang mengatakan bahwa setiap orang berhak hidup sejahtera lahir dan batin, bertempat tinggal, dan mendapatkan lingkungan hidup yang baik dan sehat serta berhak memperoleh pelayanan kesehatan dan pasal 34 ayat (1) yang mengatakan bahwa Negara mengembangkan sistem jaminan sosial bagi seluruh rakyat dan memberdayakan masyarakat yang lemah dan tidak mampu sesuai dengan martabat kemanusiaan dan ayat (2) yang menetapkan bahwa Negara bertanggung jawab atas penyediaan fasilitas pelayanan kesehatan dan fasilitas pelayanan umum yang layak, maka sudah merupakan kewajiban negara untuk menjamin kesehatan warganya. Berbagai program telah dikembangkan oleh Negara termasuk Jaminan Kesehatan Masyarakat (Jamkesmas). Akan tetapi pada pelaksanaannya, Jamkesmas ini masih banyak menemui kendala. Makalah ini akan menjabarkan informasi terkait dengan pelaksanaan program Jamkesmas dan memberikan berbagai pemecahan masalah tersebut. AbstractHealth is a human right. In accordance with Pancasila and 1945 Constitution, namely Article 28H paragraph (1) which says that every person is entitled to live in prosperity and spiritual, living, and earn a good living environment and healthy and receive medical care and article 34 paragraph (1) the said that the State develop a system of social security for all citizens and to empower the weak and unable to human dignity and in accordance with paragraph (2) which provides that the State is responsible for the provision of health care facilities and public service facilities are decent, then it is the obligation of the state to ensure the health of its citizens. Various programs have been developed by the State including Community Health Insurance (Jamkesmas). However, in practice, this is still a lot of obstacles. This paper will describe the information related to the implementation of the program Jamkesmas and provide a variety of problem solving.

scholarly journals Targeting and Impact of National Health Insurance Program in Indonesia

2020 ◽  
Vol 9 (4) ◽  
pp. 468-481
Author(s):  
Galih Putri Yunistria
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Health Insurance ◽  
National Health Insurance ◽  
Logistic Regression Analysis ◽  
National Health ◽  
Health Care Facilities ◽  
National Health Insurance System ◽  
Care Facilities

National Health Insurance System (NHIS) program in Indonesia has been launched since 2014,and government spending to support the program has allocated nearly 40% of MoH budget,especially for the NHIS subsidies. This study examined the distribution of NHIS subsidizedbeneficiaries which associated with the household income distribution, and also studied about theutilization rate of health care facilities among the residents since the NHIS program has introducedto change citizens’ health seeking behaviour from traditional services to health facilities. Using the2016 Susenas data, this study employed the benefit incidence analysis method to measure thedistribution of NHIS-subsidized group, and logistic regression analysis to determine the health careseeking behavior. The result shows that households in higher income (quantile III-V) get benefitfrom government subsidy on NHIS program. It indicated there was a leakage on governmentbudget that not belong to the target (quantile I and II). Then, logistic regression analysis found thatpeople with higher income and having health insurance tend to visit health care facilities morefrequently than lower income group and uninsured people. This can be concluded that healthinsurance ownership is one of the important factors to influence people visiting health carefacilities.

scholarly journals Blockchain-Enabled iWellChain Framework Integration With the National Medical Referral System: Development and Usability Study (Preprint)

2019 ◽  
Author(s):  
Yu-Sheng Lo ◽  
Cheng-Yi Yang ◽  
Hsiung-Fei Chien ◽  
Shy-Shin Chang ◽  
Chung-Ying Lu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health ◽  
Health Care Facilities ◽  
Health Record ◽  
National Medical ◽  
Referral Service ◽  
Care Facilities ◽  
Access Logs ◽  
Medical Referral

BACKGROUND Medical referral is the transfer of a patient’s care from one physician to another upon request. This process involves multiple steps that require provider-to-provider and provider-to-patient communication. In Taiwan, the National Health Insurance Administration (NHIA) has implemented a national medical referral (NMR) system, which encourages physicians to refer their patients to different health care facilities to reduce unnecessary hospital visits and the financial stress on the national health insurance. However, the NHIA’s NMR system is a government-based electronic medical referral service, and its referral data access and exchange are limited to authorized clinical professionals using their national health smart cards over the NHIA virtual private network. Therefore, this system lacks scalability and flexibility and cannot establish trusting relationships among patients, family doctors, and specialists. OBJECTIVE To eliminate the existing restrictions of the NHIA’s NMR system, this study developed a scalable, flexible, and blockchain-enabled framework that leverages the NHIA’s NMR referral data to build an alliance-based medical referral service connecting health care facilities. METHODS We developed a blockchain-enabled framework that can integrate patient referral data from the NHIA’s NMR system with electronic medical record (EMR) and electronic health record (EHR) data of hospitals and community-based clinics to establish an alliance-based medical referral service serving patients, clinics, and hospitals and improve the trust in relationships and transaction security. We also developed a blockchain-enabled personal health record decentralized app (DApp) based on our blockchain-enabled framework for patients to acquire their EMR and EHR data; DApp access logs were collected to assess patients’ behavior and investigate the acceptance of our personal authorization-controlled framework. RESULTS The constructed iWellChain Framework was installed in an affiliated teaching hospital and four collaborative clinics. The framework renders all medical referral processes automatic and paperless and facilitates efficient NHIA reimbursements. In addition, the blockchain-enabled iWellChain DApp was distributed for patients to access and control their EMR and EHR data. Analysis of 3 months (September to December 2018) of access logs revealed that patients were highly interested in acquiring health data, especially those of laboratory test reports. CONCLUSIONS This study is a pioneer of blockchain applications for medical referral services, and the constructed framework and DApp have been applied practically in clinical settings. The iWellChain Framework has the scalability to deploy a blockchain environment effectively for health care facilities; the iWellChain DApp has potential for use with more patient-centered applications to collaborate with the industry and facilitate its adoption.

scholarly journals Blockchain-Enabled iWellChain Framework Integration With the National Medical Referral System: Development and Usability Study

10.2196/13563 ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. e13563 ◽  
Author(s):  
Yu-Sheng Lo ◽  
Cheng-Yi Yang ◽  
Hsiung-Fei Chien ◽  
Shy-Shin Chang ◽  
Chung-Ying Lu ◽  
...  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health ◽  
Health Care Facilities ◽  
Health Record ◽  
National Medical ◽  
Referral Service ◽  
Care Facilities ◽  
Access Logs ◽  
Medical Referral

Background Medical referral is the transfer of a patient’s care from one physician to another upon request. This process involves multiple steps that require provider-to-provider and provider-to-patient communication. In Taiwan, the National Health Insurance Administration (NHIA) has implemented a national medical referral (NMR) system, which encourages physicians to refer their patients to different health care facilities to reduce unnecessary hospital visits and the financial stress on the national health insurance. However, the NHIA’s NMR system is a government-based electronic medical referral service, and its referral data access and exchange are limited to authorized clinical professionals using their national health smart cards over the NHIA virtual private network. Therefore, this system lacks scalability and flexibility and cannot establish trusting relationships among patients, family doctors, and specialists. Objective To eliminate the existing restrictions of the NHIA’s NMR system, this study developed a scalable, flexible, and blockchain-enabled framework that leverages the NHIA’s NMR referral data to build an alliance-based medical referral service connecting health care facilities. Methods We developed a blockchain-enabled framework that can integrate patient referral data from the NHIA’s NMR system with electronic medical record (EMR) and electronic health record (EHR) data of hospitals and community-based clinics to establish an alliance-based medical referral service serving patients, clinics, and hospitals and improve the trust in relationships and transaction security. We also developed a blockchain-enabled personal health record decentralized app (DApp) based on our blockchain-enabled framework for patients to acquire their EMR and EHR data; DApp access logs were collected to assess patients’ behavior and investigate the acceptance of our personal authorization-controlled framework. Results The constructed iWellChain Framework was installed in an affiliated teaching hospital and four collaborative clinics. The framework renders all medical referral processes automatic and paperless and facilitates efficient NHIA reimbursements. In addition, the blockchain-enabled iWellChain DApp was distributed for patients to access and control their EMR and EHR data. Analysis of 3 months (September to December 2018) of access logs revealed that patients were highly interested in acquiring health data, especially those of laboratory test reports. Conclusions This study is a pioneer of blockchain applications for medical referral services, and the constructed framework and DApp have been applied practically in clinical settings. The iWellChain Framework has the scalability to deploy a blockchain environment effectively for health care facilities; the iWellChain DApp has potential for use with more patient-centered applications to collaborate with the industry and facilitate its adoption.

scholarly journals Status and determinants of enrollment and dropout of health insurance in Nepal: an explorative study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Chhabi Lal Ranabhat ◽  
Radha Subedi ◽  
Sujeet Karn
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Numerical Data ◽  
Social Health Insurance ◽  
Health Care Facilities ◽  
Social Health ◽  
Dropout Rates ◽  
Group Discussions ◽  
Insurance Program ◽  
Care Facilities

Abstract Background Compared to other countries in the South Asia Nepal has seen a slow progress in the coverage of health insurance. Despite of a long history of the introduction of health insurance (HI) and a high priority of the government of Nepal it has not been able to push rapidly its social health insurance to its majority of the population. There are many challenges while to achieve universal health insurance in Nepal ranging from existing policy paralysis to program operation. This study aims to identify the enrollment and dropout rates of health insurance and its determinants in selected districts of Nepal. Methods The study was conducted while using a mixed method including both quantitative and qualitative approaches. Numerical data related to enrollment and dropout rates were taken from Health Insurance Board (HIB) of Nepal. For the qualitative data, three districts, Bardiya, Chitwan, and Gorkha of Nepal were selected purposively. Enrollment assistants (EA) of social health insurance program were taken as the participants of study. Focus group discussions (FGD) were arranged with the selected EAs using specific guidelines along with unstructured questions. The results from numerical data and focus group discussions are synthesized and presented accordingly. Results The findings of the study suggested variation in enrollment and dropout of health insurance in the districts. Enrollment coverage was 13,545 (1%), 249,104 (5%), 1,159,477 (9%) and 1,676,505 (11%) from 2016 to 2019 among total population and dropout rates were 9121(67%), 110,885 (44%) and 444,967 (38%) among total enrollment from 2016 to 2018 respectively. Of total coverage, more than one-third proportion was subsidy enrollment—free enrollment for vulnerable groups. The population characteristics of unwilling and dropout in social health insurance came from relatively well-off families, government employees, businessman, migrants’ people, some local political leaders as well as the poor class families. The major determinants of poor enrollment and dropout were mainly due to unavailability of enough drugs, unfriendly behavior of health workers, and indifferent behavior of the care personnel to the insured patients in health care facilities and prefer to take health service in private clinic for their own benefits. The long maturation time to activate health service, limited health package and lack of copayment in different types of health care were the factors related to inefficient program and policy implementation. Conclusion There is a high proportion of dropout and subsidy enrollment, the key challenge for sustainability of health insurance program in Nepal. Revisiting of existing HI policy on health care packages, more choices on copayment, capacity building of enrollment assistants and better coordination between health insurance board and health care facilities can increase the enrollment and minimize the dropout.

scholarly journals Does Micro Health Insurance Solve the Problem of Providing Accessible Healthcare to the Poor? Evidence from Niramoy Project, Bangladesh

2014 ◽  
Vol 3 (1) ◽  
pp. 55-64
Author(s):  
Md. Mizanur Rahman ◽  
Sakufa Chowdhury
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Distribution Channel ◽  
Jel Classification ◽  
Health Care Facilities ◽  
Micro Health Insurance ◽  
Classification Code ◽  
The Poor ◽  
Insurance Program ◽  
Care Facilities

Billion of people in the world are out of reach from the modern health care facilities and medicine. Micro health insurance is one of the methods of providing accessible health care facilities to the poor. Micro health insurance in Bangladesh provides basic health care at an affordable rate for the poor and the ultra-poor. The traditional insurance program consists of front cash at each stage of service delivery, but micro health insurance scheme with its partner-agent model based distribution channel cover the adequate risk protection, inclusivity of access, affordability and program sustainability. The results of the analysis showed that micro health insurance program in Bangladesh has improved at the present time, but the increased access cannot reduce the essential health-related costs of marginal household. JEL Classification Code: G22; J65

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