Healthcare delivery - risk pooling, Biology

Healthcare Delivery - Risk Pooling

Providing effective healthcare delivery involves the establishment of medical centres across the country in such a way that they are easily accessible/affordable to all sections of the people. A sufficiently large network of centres would have to be functioning so as to conveniently cater to the health needs of the people. Such needs can be grouped into two types of services: basic services for normal healthcare needs requiring treatment for short duration (referred to as OPD services) and long term treatment for complicated ailments requiring hospitalisation. The financial implications of meeting the requirement of such needs, both for the individuals as well as for the state, are of different kinds. Depending on the magnitude of the need as determined by the geographical boundary and the population size, the budgetary needs of the state also can be substantial. In the absence of adequate/ suitable facilities, the out-of-pocket expenses incurred by the individuals will be huge.

At present, low income countries are struggling to raise the required resources to fund essential health services of a primary nature. As countries advance towards higher income brackets (i.e. middle/higher income levels), issues of universal  health coverage (which includes comprehensive health coverage), financial protection and health system efficiency assume priority. These objectives require an overhaul of the current financing structures involving technical, institutional, and political challenges. Risk pooling, in this context, refers to the collection and management of financial resources so that large unpredictable individual financial risks are distributed among all members of the pool. Pre-payment is an essential component of risk pooling. This may be either in the form of normal tax paid (using which the government sets up public health facilities of both the primary and the specialised type; which is open for usage by all the persons in general) or in the form of payment of exclusive ‘premium’ paid for health coverage (in which case the facilities are restrictively available only to the members of the system). There are various ways of meeting the financing needs of the health insurance programmes.

Four main health insurance mechanisms used to pool health risks are:

(i) State-funded systems;

(ii) Social health insurance;

(iii) Voluntary or private health insurance; and

(iv) Community-based health insurance.

The features of each one of these financing mechanisms differ significantly with no one method being inherently superior to the others. There is therefore a need to find out which one of the methods is the best suited for developing a system serving the essentials of equity, efficiency and sustainability. As discussed before, it is important to align the schemes to the country-specific economic, institutional, and cultural characteristics.

 

Posted Date: 12/17/2012 1:20:36 AM | Location : United States







Related Discussions:- Healthcare delivery - risk pooling, Assignment Help, Ask Question on Healthcare delivery - risk pooling, Get Answer, Expert's Help, Healthcare delivery - risk pooling Discussions

Write discussion on Healthcare delivery - risk pooling
Your posts are moderated
Related Questions
Question 1: "Plant tissue culture now has direct commercial applications" Explain. Describe plant tissue culture Illustrate importance of plant tissue culture Sho

Q. What are the Symptoms of acute pericarditis? Chest Pain Chest pain is the most important symptom. It is retrosternal in location and patient usually locates the site o

What is NAD? What is the role of the NAD molecule in glycolysis? NAD (nicotinamide adenine dinucleotide) is a hydrogen acceptor essential as reductant (to receive hydrogen) in

factors affecting nitrogen balance

Define Food Science and Simple Sugars? This first unit introduces the concept, scope and importance of food science and technology as a discipline. It further presents a detail

Hormones in Metamorphosis of Amphibia In amphibians, the changes that take place during metamorphosis are brought about by hormonal secretions of the thyroid gland. The first

Case scenario Mr Kit Lee, a 28-year-old unrestrained driver of a utility, was travelling on a highway at 100kph and swerved to miss road debris. He lost control and struck a tre

ADP-ATP system  of energy  exchange : In 1929 Lohmann, Fiske and  subbarow  published  their  discovery  that the energy  exchanges  compounds in all biological  systems  are t

What are sols?  A colloidal system in which solid  particles are dispersed in a liquid is referred to as a sol, to distinguish it from a true solution. In a true solution, the

Explain what is Cyanosis and polycythemia? Cyanosis and Polycythemia: Central cyanosis involving the mucous membranes and trunk along with the lips and extremities in absence