A Comparative study on the cost effectiveness of intervention of noncommunicable disease in south Darfur 2017

Background: This study conducted to assess the cost effectiveness of common interventions used to control Noncommunicable diseases in south Darfur. Noncommunicable diseases are becoming an increasing public health concern due to their economic significance, and their great impact on the ability of affected individuals to contribute to their communities, and the high burden it represents on the health system. Objectives: To evaluate the role of health insurance fund in controlling Noncommunicable diseases. To assess cost effectiveness of the management of Noncommunicable disease within the National Health insurance fund system. Methods: This study is designed to use secondary data from the national health insurance fund in south Darfur, comparing the cost for the management of 3 selected Noncommunicable diseases (Hypertension, Heart disease, and Diabetes). I have reviewed the entire data of the year 2017 and compared the cost effectiveness of the currently used interventions against health promotion and coordinated approach within the national health insurance fund. Results: The 3 selected disease (Heart Disease, Hypertension and Diabetes) has significant burden on the health system, both financially and operationally. The NHIF concentrates on the management of Noncommunicable diseases without paying due attention to the importance of prevention strategies such as health promotion, community based integrated management of NCDs, and coordination among other sectors. Conclusion: To effectively reduce the financial burden of Noncommunicable disease; the NHIF needs to concentrate on prevention of Noncommunicable diseases through extensive health promotion campaigns, promotion of healthy lifestyle, and coordinated approach to controlling Noncommunicable disease.

Pros and Cons of National Health Insurance Fund in Sudan: A Critical Review

Introduction: National Health Insurance Fund (NHIF) is a semi-autonomous and national organization which is politically affiliated to Ministry of labor and social security and Woman and Child Affairs. NHIF is pointing to mitigate the risks of high cost of health services on both the government and population and securing the quality and accessibility of health services. Aim: this review is aiming to identify, and summarize the findings of relevant studies on the factors that affect NHIF in Sudan to be more accessible for decision makers to take a strategic decisions towards the universal health coverage. Methods: a qualitative exploratory analytical study. The study conducted on National Health Insurance Fund in Khartoum State. The study population was composed of the current literature that clarifying the research question. This study used SALSA framework: the Search, Appraisal, Synthesis, and Analysis framework which is a simple framework divides the review process into four main stages: (1) search (2) appraisal (3) synthesis and (4) analysis. Results: One of NHIF strengthen that it has a large coverage of population but it has low utilization of services by subscribers which considered as threat. Safeguarding health service users especially the poor against the implication of the market liberation policy embarked on by the Sudanese government is considered as opportunity to ensure the financial risk protection at NHIF but existence of The Federal Ministry of Finance as the major contributor in financing NHIF is a threat faces NHIF sustainability. Conclusion: This critical review shows that National Health Insurance Fund (NHIF) affected by many internal and external favorable and unfavorable factors. Those factors are: strengthens, weaknesses, opportunities, threats of NHIF which should be taken in consideration to achieve universal health coverage.

Availability and reimbursement of biological products for severe asthma in Bulgaria

Objectives: This study aims to analyze the reimbursement and cost of biological therapy for severe asthma in Bulgaria during 2014–2019 from the perspective of the National Health Insurance Fund. Methods: It is a retrospective, Marco-costing, top-down study of the expenditures for biological products for severe asthma. The changes in the cost paid by the National Health Insurance Fund per year, per product, and per patient during 2015–2020 were systematized and calculated. The utilization of biologicals was analyzed by calculating the defined daily dose/1000inh/day. Three databases were searched—the European Medicines Agency for the date of marketing authorization of biological products, National Council of Prices and Reimbursement for the date of their respective inclusion in the positive drug list, and National Health Insurance Fund about the number of patients with asthma, reimbursed sum for all asthma patients, and number of packages sold of biological products. Results: At the end of 2019, five international non-proprietary names of biologicals with indication for severe asthma had received European marketing authorization, and three of them were included in the Bulgarian positive drug list—omalizumab, mepolizumab, and benralizumab with a 75% reimbursement. Upon their introduction into the positive drug list, the reimbursed expenditures for asthma therapy started to increase from 27 million in 2014 to 33 million BGN in 2019 (€13.5–€16.5 million). The cost of therapy with biologicals rose from 16% to 24% of all anti-asthmatic medicines budget. The National Health Insurance Fund database reported that between 47,000 and 52,000 of patients with asthma, 466 are on biological therapy. The yearly cost of one asthma patient ranges between 512 and 615 BGN (€258–€307), and the yearly per-patient cost of severe asthma is 16,666 BGN (appr. €8333). Total utilization in defined daily dose/1000inh/day increases from 0.0199 to 0.0383 from 2015 to 2019. Conclusion: The access to biological therapy through the reimbursement system has improved during the last 3 years. The cost of therapy is posing a high burden on the National Health Insurance Fund and on the patients and is expected to increase due to the small number of patients on biological therapy currently in comparison to all reimbursed asthmatics.

Balanced Score Card and Service Delivery at National Health Insurance Fund in Mombasa County, Kenya

The Public sector plays a critical role in the effective delivery of public services that are essential to the functioning of a state economy. The service delivery in the public sector has been noted to be ineffective due to self-interest service from the public sector officers, unlike the private sector, where focus is primarily on shareholder value. The study examined the effect of the balanced scorecard and service delivery at the national health insurance fund in Mombasa County, Kenya. The specific objectives of the study were to determine the effect of the financial perspective of the balanced scorecard, the effect of customer perspective of the balanced scorecard, the internal business perspective of balanced and examine the effect of innovation and learning perspective of balanced scorecard on service delivery at national health insurance fund in Mombasa County. The study is anchored on Balanced score card model and agency theory. The study adopted a descriptive survey research design that depicts the attributes of a specific circumstance, occasion, or case. The targeted population of the study was 158 and the respondents were senior managers, middle level managers, lower level managers and the support staff working at national health insurance fund in Mombasa County. The study finds that the balanced scorecard improves systems of the cost structure, the organization creates more revenue opportunities, net shareholder value is maintained and the asset is well utilized. Additionally, it can be concluded that most employees are delighted with the financial evaluation process by use of the balanced scorecard. The study found a positive relationship between the balanced scorecard components namely customer focus, financial perspective, customer perspective, internal business perspective, innovation, learning aspect and service delivery. The study concluded that customer focus to enhance the service delivery could be through implementing customer satisfaction measures, implementing customer service charter, maintaining product functionality, maintaining customer relationship management and maintaining customer loyalty. The study recommended that the need for NHIF to achieve the balanced scorecard to be able to track financial results while simultaneously monitoring progress through building the capabilities and as well acquiring the intangible assets they would need future growth. Also, the study recommended the organization to consider the issue cost minimization strategy to enhance the service delivery to the customers. In addition to that, there is a need to have a permanent solution to steady funds to be able to meet its obligations. The study further recommended that the organization to embrace the balanced scorecard and will help improve communication between the management and customers thus improve on the quality service hence satisfy the needs of the customers.

A terápiás apheresisek számának és indikációjának változása, valamint új eljárások megjelenése Magyarországon 2013 és 2017 között

Therapeutic apheresis is a treatment option for several subspecialities. It is a relatively expensive intervention, which can only be done by dedicated centers based on specific indications. The Therapeutic Apheresis Committee and the National Health Insurance Fund of Hungary jointly control the number of interventions to be made, the introduction of new diagnoses and the application of new apheresis procedures in Hungary. In this work, we review the therapeutic practice of the period between 2013 and 2017 in Hungary, describing also the new modalities under implementation. Orv Hetil. 2019; 160(19): 727–738.

A rokkantság, megváltozott munkaképesség, rehabilitációs ellátások változása Magyarországon 1990 és 2015 között

Introduction: In our study, based on the data of the last 25 years, we analyzed the changes in the cash benefits paid to people with reduced working capacity, currently accounting for nearly 30% of the budget of the National Health Insurance Fund of Hungary. Aim: The purpose of our study is to compare the statistical data of the past 25 years and the changes in the legal environment. Methods: Our research was based on the data series of the National Health Insurance Fund of Hungary and the Hungarian Central Statistical Office as well as on the public finance reports of the State Audit Office of Hungary and the Ministry for National Economy. For the period under review, we analyzed the extent of the cash benefits paid to people with reduced working capacity, the measures taken to reduce these benefits, and the related legal background. In the long term, we examined the relevant dimension of the complex sociological processes in the background as well as the medical evaluation of the changed working ability. Results: In the last 25 years, benefits (annuity, retirement) paid under different denominations (disability, work ability reduction, health impairment, rehabilitation benefit) are still a decisive part of the health insurance budget (HUF 315 billion in 2016). Serious efforts have been made to replace the previously funded system of invalidity pension and annuity system, with the complex medical, occupational, and social rehabilitation, maintenance and improvement of the remaining state of health. The purpose of the measures is essentially to reduce budget expenditures and to improve the utilization of the amount paid on rehabilitation benefits. Conclusion: The sociological changes that occurred during the long period of time regrettably helped to initially increase the number of recipients of invalidity benefits, to stabilize them at a high level and to have a significant burden on the budget. This could not be counterbalanced by the rehabilitation approach of money supply either. Orv Hetil. 2019; 160(Suppl 1): 29–36.