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Health Expenditure and Healthcare Financing Arrangements - Coggle Diagram
Health Expenditure and Healthcare Financing Arrangements
Health care expenditures are any expenditure made within the health care system to protect or
restore health.
(a) Current or operating expenditures (or Title I)
fees or remuneration of practitioners
consumption of
medicines and consumables
accommodation costs for hospitalized patients
(b) Investment or capital expenditures (or Title II)
the costs of building health
care infrastructures
acquiring equipment
The health accounts and the main aggregates of the health accounts
The health accounts trace the
production
consumption
financing of health expenditures
The health accounts record all expenditures, whether publicly or privately financed
the health accounts provide
significant aggregates
main aggregates are calculated in the health accounts
Consumption of health care and medical goods (CHCMG)
It includes
hospital care
outpatient care
patient
transport
medicines
Current health expenditure
adds to the consumption of medical care and goods:
Individualized expenditures that do not take the form of health goods and services
Expenditures related to the operation and development of the health system
Expenditure on preventive programs, whether individual (screening, vaccinations etc.) or
collective (health information and education campaigns)
Total Health Expenditure (THE)
THE is defined as current health expenditure
reduced daily allowances, a portion of preventive spending on training of health personnel and
on medical and pharmaceutical research.
And increased gross investment by producers of health goods and services and certain health
expenditures related to the care of disabled or independent elderly people.
Health expenditure indicators for health system performance comparisons
a selection of indicators frequently used in the Health System Comparisons They apply to:
THE
TCHE
TPHE
They can be
expressed in the following forms:
Expenditure per capita
Real per capita health expenditure
Share of health expenditure in gross domestic product GDP
Explanatory factors for the increase in health care expenditures in the world
A. Pragmatic Reasons:
The increase in the supply of care that is linked to:
The development of diagnostic and therapeutic technologies
The increase in the number of health professionals
The hyperspecialization of the medical professions
The development of new drugs without the withdrawal of old ones from the market
etc...
Easy and/or facilitated access to abundant medical information
The increase in life expectancy which results in:
An aging population
The increased fear of death
Changing lifestyles
Free care for all
B. Theoretical Reasons:
The theory of induced demand
The concept of induced demand corresponds to the
influence of supply on demand
the existence of a high medical and hospital density
an increasingly well-informed and demanding population
an ignorant population that is not very sensitive to prices and is guided by the doctor
Moral hazard
The difficult regulation by the market
equilibrium process is possible only under certain conditions:
individuals are rational, free and perfectly informed
companies compete with each other
supply is a strictly increasing function of price
demand grows with the social utility of the product in question
Health Care Financing Arrangements
A. Fundraising:
There are eight big mechanisms
for collecting contributions:
direct payments
Optional contributions to an income-related health insurance fund
optional risk-related contributions
compulsory contributions to a health insurance fund
taxes
turnover taxes
donations from non-governmental organizations
transfers from donor agencies
B. Pooling Funds:
It is the accumulation of resources from prepayments for health care, such as health insurance
contributions (Financial Intermediary) that can be used for a population.
C. The purchase:
It transfers pooled resources to health care providers so that effective and responsive services are
made available to the population.
Controlling health care expenditures
A. Regulation by supply of care and regulation by demand
In the regulation by the supply of care
done by the control of
physical quantities (number of positions of hospital practitioners, number of beds, scanners...).
In regulating the demand for care
The aim of the implemented reforms is to make the patient accountable, either through coercive
measures or incentives by:
invest in prevention
dissociate the level of coverage from the price of services
by introducing co-payment instruments such as the user fee
Promote regulated reimbursement
Set a reimbursement ceiling for the "small risk".
B. Accounting regulation of health expenditure and medical regulation:
Accounting regulation
involves defining rules for resource allocation and payment.
Medical regulation
refers to the notion of fair care: efficiency and medical utility are the only criteria considered valid to eliminate waste and obtain a decrease in expenditure.
C. Regulation through evaluation:
regulation through evaluation aims at streamlining expenditure and helping to decide on the allocation of
available resources.