Measuring primary healthcare expenditure in low-income and lower middle-income countries.

Autor:	Vande Maele N; Health Systems Governance and Financing, Organisation mondiale de la Sante, Geneve, Switzerland., Xu K; Health Systems Governance and Financing, Organisation mondiale de la Sante, Geneve, Switzerland., Soucat A; Health Systems Governance and Financing, Organisation mondiale de la Sante, Geneve, Switzerland., Fleisher L; Freelance consultant, Washington, District of Columbia, USA., Aranguren M; Health Systems Governance and Financing, Organisation mondiale de la Sante, Geneve, Switzerland., Wang H; Global Development Division, The Bill and Melinda Gates Foundation, Seattle, Washington, USA.
Jazyk:	angličtina
Zdroj:	BMJ global health [BMJ Glob Health] 2019 Feb 21; Vol. 4 (1), pp. e001497. Date of Electronic Publication: 2019 Feb 21 (Print Publication: 2019).
DOI:	10.1136/bmjgh-2019-001497
Abstrakt:	Primary healthcare (PHC) is considered as the pathway to Universal Health Coverage (UHC) and to achieving sustainable development goals. Measuring PHC expenditure is a critical first step to understanding why some countries improve access to health services, provide financial risk protection and achieve UHC. In this paper, we tested and examined different measurement options using the System of Health Accounts (SHA) 2011 for systematic monitoring of PHC expenditure. We used the 'first-contact' approach to PHC and applied it to the healthcare function or healthcare provider classifications of SHA 2011. Data comes from 36 recent low-income and middle-income countries health accounts 2011-2016. Country spending on PHC varies largely, across countries and across definition options. For example, PHC expenditure ranges from US$15 to US$60 per capita. The sensitivity analysis highlighted the weight of including or excluding medical goods. The correlation analysis comparing countries ranking is strong between options. The study identified the major challenges in developing standard monitoring of PHC expenditure. One, there is a lack of clear operational definition for PHC, suggesting that a global standard definition would not replace the need for country context specific definition. Two, there is insufficient data granularity both because the standard framework does not offer it and because quality data breakdown is unavailable. Competing Interests: Competing interests: None declared.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu