DOCSLIB.ORG

An Examination of the Potential Costs of Universal Health Insurance in Ireland

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
An Examination of the Potential Costs of Universal Health Insurance in Ireland An Examination of the Potential Costs of Universal Health Insurance in Ireland Maev-Ann Wren, Sheelah Connolly, Nathan Cunningham RESEARCH SERIES NUMBER 45 Report prepared for the Department of Health by the Economic and Social Research Institute (ESRI) September 2015 Available to download from www.esri.ie © Economic and Social Research Institute and the Minister for Health, September 2015 ISBN 978-0-7070-0392-4 The ESRI The Economic Research Institute was founded in Dublin in 1960, with the assistance of a grant from the Ford Foundation of New York. In 1966 the remit of the Institute was expanded to include social research, resulting in the Institute being renamed the Economic and Social Research Institute (ESRI). In 2010 the Institute entered into a strategic research alliance with Trinity College Dublin, while retaining its status as an independent research institute. The ESRI is governed by an independent Council which acts as the board of the Institute with responsibility for guaranteeing its independence and integrity. The Institute’s research strategy is determined by the Council in association with the Director and staff. The research agenda seeks to contribute to three overarching and interconnected goals, namely, economic growth, social progress and environmental sustainability. The Institute’s research is disseminated through international and national peer reviewed journals and books, in reports and books published directly by the Institute itself and in the Institute’s working paper series. Researchers are responsible for the accuracy of their research. All ESRI books and reports are peer reviewed and these publications and the ESRI’s working papers can be downloaded from the ESRI website at www.esri.ie The Institute’s research is funded from a variety of sources including: an annual grant-in-aid from the Irish Government; competitive research grants (both Irish and international); support for agreed programmes from government departments/agencies and commissioned research projects from public sector bodies. Sponsorship of the Institute’s activities by Irish business and membership subscriptions provide a minor source of additional income. The Authors Maev-Ann Wren is a Senior Research Officer, Sheelah Connolly is a Research Officer and Nathan Cunningham is a Data Analyst at the Economic and Social Research Institute, Dublin. Acknowledgements Financial support for this research was provided by the Department of Health. The authors would like to thank the members of the Steering Group of the ESRI Research Programme in Healthcare Reform for their support, input and encouragement. The authors would particularly like to thank Laura McGarrigle and Robert Murphy of the Department of Health for their assistance to this research project. The authors are also grateful to the many officials of the Department of Health and HSE, who have assisted this research, including the staff of the newly established Healthcare Pricing Office. The authors would like to acknowledge the invaluable assistance of the Central Statistics Office in completing this research. The authors would like to acknowledge the contributions of colleagues at the ESRI; in particular Richard Layte, Anne Nolan, Tim Callan and Patricia Carney, who contributed to various stages of this research. Valuable comments on the text and suggestions for revision were provided by three anonymous reviewers. We would like to thank them for their contributions while acknowledging that the authors bear sole responsibility for the analyses and interpretations presented. This report has been accepted for publication by the Institute, which does not itself take institutional policy positions. All ESRI Research Series reports are peer reviewed prior to publication. The authors are solely responsible for the content and the views expressed. Table of Contents | i Table of Contents ABBREVIATIONS ...................................................................................................................................... VIII GLOSSARY OF TERMS ................................................................................................................................. X FOREWORD ............................................................................................................................................. XII EXECUTIVE SUMMARY ............................................................................................................................ XIII CHAPTER 1 INTRODUCTION ......................................................................................................................1 1.1 Objectives of this Study .............................................................................................1 1.2 Context ......................................................................................................................2 1.3 Background ................................................................................................................4 1.4 Conceptual and Definitional Issues ...........................................................................9 1.5 Structure of the Report .......................................................................................... 11 CHAPTER 2 DATA AND METHODS .......................................................................................................... 13 2.1 Introduction ............................................................................................................ 13 2.2 Overview of Methodology and Definitions ............................................................ 13 2.3 Data Sources ........................................................................................................... 16 2.4 Preliminary Analysis - Methods .............................................................................. 18 2.5 Estimating the cost of the White Paper Model of UHI - Methods ......................... 22 2.6 Conclusion .............................................................................................................. 42 CHAPTER 3 INTERNATIONAL EVIDENCE ON HEALTHCARE FINANCING MODELS AND HEALTHCARE EXPENDITURE ...................................................................................................................... 44 3.1 Introduction ............................................................................................................ 44 3.2 Financing of Health Systems ................................................................................... 44 3.3 The Relationship between System Design Features and Healthcare Expenditure ............................................................................................................ 47 3.4 Determinants of Healthcare Expenditure .............................................................. 60 3.5 Cost Containment in the Healthcare Sector ........................................................... 62 3.6 Cross-Country Comparisons ................................................................................... 65 3.7 Summary of Country Case Studies ......................................................................... 70 3.8 Concluding Reflections ........................................................................................... 74 CHAPTER 4 TRENDS IN IRISH HEALTHCARE EXPENDITURE 2004-2013 .................................................. 78 4.1 Introduction ............................................................................................................ 78 4.2 Total Healthcare Expenditure ................................................................................. 78 4.3 Public Healthcare Expenditure ............................................................................... 80 4.4 Private Healthcare Expenditure.............................................................................. 85 4.5 Programme Expenditure ........................................................................................ 89 4.6 Pay-and-Pension-Related Expenditure ................................................................... 90 4.7 Conclusion .............................................................................................................. 94 ii | An Examination of the Potential Costs of Universal Health Insurance in Ireland CHAPTER 5 FINDINGS ON THE POTENTIAL EFFECTS OF THE WHITE PAPER UHI MODEL ON IRISH HEALTHCARE EXPENDITURE AND FINANCING .................................................................... 95 5.1 Introduction ............................................................................................................ 95 5.2 Estimation of Irish Healthcare Expenditure and Financing - Findings .................... 97 5.3 Cost of the White Paper Model of UHI – Findings................................................ 107 5.4 Conclusion ............................................................................................................ 123 CHAPTER 6 CONCLUDING DISCUSSION ................................................................................................ 125 6.1 Background to this Analysis .................................................................................. 125 6.2 Reflections on our Findings from the International Evidence .............................. 125 6.3 Reflections on our Findings from Analysis of Irish Healthcare Expenditure ........ 126 6.4 Reflections on our Findings from Analysis of the Potential Effects of the White Paper Model of UHI Financing ..................................................................
Load more

Recommended publications
  • Health Climate Change Sectoral Adaptation Plan 2019-2024
    Health Climate Change Sectoral Adaptation Plan 2019-2024 Prepared under the National Adaptation Framework Prepared by the Department of Health www.gov.ie/health Health Climate Change Sectoral Adaptation Plan 2019-2024 1 Contents Foreword 5 Executive Summary 7 Development of a Plan for Ireland’s Health Sector, 2019 – 2024 7 Six climate scenarios with profound health implications 8 Predicted climate risks and health impacts for Ireland include: 10 1. Introduction 11 Mandate and vision 12 Health context and the case for adaptation 13 Mainstreaming climate change adaptation 14 Limitations – more research, better data 15 Development of this Plan 16 2. Scene-setting: climate change, health, and Ireland 21 2.1. Health in Ireland, climate in Ireland 22 2.1.1 Health of the population 22 2.1.2 Climate in Ireland 23 2.1.3 Climate change projections for Ireland 23 2.2. Effect of climate change on human health 24 2.3. Health implications of climate change in Ireland 24 2.3.1 Health impacts of temperature changes 24 2.3.2 Health impacts of drought and flooding 29 2.3.3 Health impacts of storms 32 2.3.4 Mental health impacts 32 2.3.5 Risks to health services 32 3. Prioritisation 35 3.1. Climate Impact Screening 36 3.2. Developing Priorities 38 3.3. Climate scenarios – Priority Impacts 41 3.3.1 UV / Sun exposure 41 3.3.2 Air pollution 41 3.3.3 Windstorms 41 3.3.4 Heat / Heatwaves 42 3.3.5 High precipitation / Flooding 43 3.3.6 Extreme cold snaps 43 2 Contents 4.
    [Show full text]
  • Health Systems in Transition (HIT) : France
    Health Systems in Transition Vol. 17 No. 3 2015 France Health system review Karine Chevreul Karen Berg Brigham Isabelle Durand-Zaleski Cristina Hernández-Quevedo Cristina Hernández-Quevedo (Editor), Ellen Nolte and Ewout van Ginneken (Series editors) were responsible for this HiT Editorial Board Series editors Reinhard Busse, Berlin University of Technology, Germany Josep Figueras, European Observatory on Health Systems and Policies Martin McKee, London School of Hygiene & Tropical Medicine, United Kingdom Elias Mossialos, London School of Economics and Political Science, United Kingdom Ellen Nolte, European Observatory on Health Systems and Policies Ewout van Ginneken, Berlin University of Technology, Germany Series coordinator Gabriele Pastorino, European Observatory on Health Systems and Policies Editorial team Jonathan Cylus, European Observatory on Health Systems and Policies Cristina Hernández-Quevedo, European Observatory on Health Systems and Policies Marina Karanikolos, European Observatory on Health Systems and Policies Anna Maresso, European Observatory on Health Systems and Policies David McDaid, European Observatory on Health Systems and Policies Sherry Merkur, European Observatory on Health Systems and Policies Dimitra Panteli, Berlin University of Technology, Germany Wilm Quentin, Berlin University of Technology, Germany Bernd Rechel, European Observatory on Health Systems and Policies Erica Richardson, European Observatory on Health Systems and Policies Anna Sagan, European Observatory on Health Systems and Policies Anne
    [Show full text]
  • Universal Health Coverage: Moving Towards Better Health
    Universal Health Coverage: Moving Towards Better Health Action Framework for the Western Pacific Region Universal Health Coverage: Moving Towards Better Health Action Framework for the Western Pacific Region WHO Library Cataloguing-in-Publication Data Universal Health Coverage: Moving Towards Better Health – Action Framework for the Western Pacific Region 1.Delivery of health care. 2. Regional health planning. 3. Universal coverage. I. World Health Organization Regional Office for the Western Pacific. ISBN 978 92 9061 756 3 (NLM Classification: W84.1) © World Health Organization 2016 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press: World Health Organization – 20, avenue Appia – 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for non-commercial distribution – should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/ copyright_form/en/index.html). For WHO Western Pacific Region publications, requests for permission to reproduce should be addressed to Publications Office, World Health Organization, Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines, fax: +632 521 1036, e-mail: [email protected] The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
    [Show full text]
  • Republic of Korea Health System Review
    Health Systems in Transition Vol. 11 No. 7 2009 Republic of Korea Health system review Chang Bae Chun • Soon Yang Kim Jun Young Lee • Sang Yi Lee Health Systems in Transition Chang Bae Chun, National Health Insurance Corporation Soon Yang Kim, Yeungnam University Jun Young Lee, University of Seoul Sang Yi Lee, Jeju National University Republic of Korea: Health System Review 2009 The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Offi ce for Europe, the Governments of Belgium, Finland, Norway, Slovenia, Spain and Sweden, the Veneto Region of Italy, the European Investment Bank, the World Bank, the London School of Economics and Political Science, and the London School of Hygiene & Tropical Medicine. Keywords: DELIVERY OF HEALTH CARE EVALUATION STUDIES FINANCING, HEALTH HEALTH CARE REFORM HEALTH SYSTEM PLANS – organization and administration REPUBLIC OF KOREA © World Health Organization 2009 on behalf of the European Observatory on Health Systems and Policies All rights reserved. The European Observatory on Health Systems and Policies welcomes requests for permission to reproduce or translate its publications, in part or in full. Please address requests about the publication to: Publications WHO Regional Offi ce for Europe Scherfi gsvej 8 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Offi ce web site (http://www.euro.who.int/PubRequest) The views expressed by authors or editors do not necessarily represent the decisions or the stated policies of the European Observatory on Health Systems and Policies or any of its partners.
    [Show full text]
  • United Nations A/HRC/WG.6/25/IRL/3
    United Nations A/HRC/WG.6/25/IRL/3 General Assembly Distr.: General 23 February 2016 Original: English Human Rights Council Working Group on the Universal Periodic Review Twenty-fifth session 2-13 May 2016 Summary prepared by the Office of the United Nations High Commissioner for Human Rights in accordance with paragraph 15 (c) of the annex to Human Rights Council resolution 5/1 and paragraph 5 of the annex to Council resolution 16/21 Ireland* The present report is a summary of 49 stakeholders’ submissions1 to the universal periodic review. It follows the general guidelines adopted by the Human Rights Council in its decision 17/119. It does not contain any opinions, views or suggestions on the part of the Office of the United Nations High Commissioner for Human Rights (OHCHR), nor any judgement or determination in relation to specific claims. The information included herein has been systematically referenced in endnotes and, to the extent possible, the original texts have not been altered. As provided for in Human Rights Council resolution 16/21, where appropriate, a separate section is provided for contributions by the national human rights institution of the State under review that is accredited in full compliance with the Paris Principles. The full texts of all submissions received are available on the OHCHR website. The report has been prepared taking into consideration the periodicity of the review and developments during that period. * The present document was not edited before being sent to United Nations translation services. GE.16-02702(E) *1602702* A/HRC/WG.6/25/IRL/3 I.
    [Show full text]
  • Impact of Cattle Access to Watercourses
    Report No. 260 Impact of Cattle Access to Watercourses: Literature Review on Behalf of the COSAINT Project Authors: Paul O’Callaghan, Mary Kelly-Quinn, Eleanor Jennings, Patricia Antunes, Matt O’Sullivan, Owen Fenton and Daire Ó hUallacháin www.epa.ie ENVIRONMENTAL PROTECTION AGENCY Monitoring, Analysing and Reporting on the The Environmental Protection Agency (EPA) is responsible for Environment protecting and improving the environment as a valuable asset • Monitoring air quality and implementing the EU Clean Air for for the people of Ireland. We are committed to protecting people Europe (CAFÉ) Directive. and the environment from the harmful effects of radiation and • Independent reporting to inform decision making by national pollution. and local government (e.g. periodic reporting on the State of Ireland’s Environment and Indicator Reports). The work of the EPA can be divided into three main areas: Regulating Ireland’s Greenhouse Gas Emissions • Preparing Ireland’s greenhouse gas inventories and projections. Regulation: We implement effective regulation and environmental • Implementing the Emissions Trading Directive, for over 100 of compliance systems to deliver good environmental outcomes and the largest producers of carbon dioxide in Ireland. target those who don’t comply. Knowledge: We provide high quality, targeted and timely Environmental Research and Development environmental data, information and assessment to inform • Funding environmental research to identify pressures, inform decision making at all levels. policy and provide solutions in the areas of climate, water and sustainability. Advocacy: We work with others to advocate for a clean, productive and well protected environment and for sustainable Strategic Environmental Assessment environmental behaviour. • Assessing the impact of proposed plans and programmes on the Irish environment (e.g.
    [Show full text]
  • Driving and Depression: Health Professional's Perspectives in Ireland ⁎ Sherrie E
    Journal of Transport & Health xxx (xxxx) xxx–xxx Contents lists available at ScienceDirect Journal of Transport & Health journal homepage: www.elsevier.com/locate/jth Driving and depression: Health professional's perspectives in Ireland ⁎ Sherrie E. Buckleya,b, , Katie Robinsonb, Tadhg Stapletonc a St. Patrick's Mental Health Services, James Street, Dublin-8 D08 K7YW, Ireland b University of Limerick, Faculty of Education and Health Science, Limerick V94 T9PX, Ireland c Trinity College Dublin, University of Dublin, School of Medicine, Trinity Centre for Health Sciences, St James Hospital, James Street, Dublin-8, Ireland ARTICLE INFO ABSTRACT Keywords: Background: Assessing the fitness to drive (FTD) of individuals with depression is important for Fitness to drive their safety and the safety of other road users. Although medical fitness to drive (FTD) guidelines Automobile driving exist in Ireland little is known about how the guidelines are used in practice or how driving is Depression addressed by health professionals. Mental health disorders Aim: To examine General Practitioners, Consultant Psychiatrists and Occupational Therapists in Respondents Ireland knowledge, attitudes and current practice related to FTD for individuals with depression. Psychiatric illness Method: A cross-sectional survey employing a purposely designed questionnaire. Results: Surveys were returned by 228 participants (60 Consultant Psychiatrists, 72 General Practitioners and 96 Occupational Therapists. Assessment of FTD was deemed important by 75% of respondents. Driving was routinely discussed by 39.5% of respondents. Clinical reasoning was considered important in FTD decisions by 91.6% of respondents, with an informal discussion/ assessment the most common type of measurement used. Respondents identified impaired cog- nition, decreased concentration, medication side-effects, suicidal ideation/intent and decreased reaction time as the factors that most influence their FTD decisions.
    [Show full text]
  • IRELAND New Developments, Trends and In-Depth Information on Selected Issues
    2006 NATIONAL REPORT (2005 Data) TO THE EMCDDA by the Reitox National Focal Point IRELAND New Developments, Trends and in-depth information on selected issues REITOX ACKNOWLEDGEMENTS This report is very much the result of collaborative work within and outside the Drug Misuse Research Division. We would like to thank very sincerely those people working in the drugs area who gave generously of their time to inform us about recent developments in their areas of work. It is not possible to name all these people but the agencies with which they are affiliated are acknowledged as follows: An Garda Síochána Central Treatment List Coroner Service Customs Drug Law Enforcement of the Revenue Commissioners Department of Health and Children Department of Community, Rural and Gaeltacht Affairs Department of Justice, Equality and Law Reform Department of Social and Family Affairs Department of Education and Science Garda National Drugs Unit Forensic Science Laboratory Health Service Executive Health Protection Surveillance Centre Addiction service managers, drug treatment facilities and general practitioners General Mortality Register Voluntary and community groups and academic researchers. We would specially like to thank the following: Mr Eddie Arthurs, Dr Joe Barry, Mr Mel Bay, Ms Deirdre Begley, Ms Carmel Brien, Ms Joan Byrne, Ms Caroline Comar, Mr Michael Conroy, Ms Caroline Corr, Dr Des Corrigan, Mr Niall Cullen, Ms Aoife Davey, Ms Aileen Dooley, Ms Cepta Dowling, Dr Brian Farrell, Ms Mary Johnston, Ms Kerry Lawless, Mr Joseph Keating, Dr Eamon
    [Show full text]
  • Tracking Universal Health Coverage: 2017 Global Monitoring Report Tracking Universal Health Coverage: 2017 Global Monitoring Report
    Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized ISBN 978 92 4 151355 5 http://www.who.int/healthinfo/universal_health_coverage/report/2017/en/ Public Disclosure Authorized Tracking Universal Health Coverage: http://www.worldbank.org/health 2017 Global Monitoring Report Tracking Universal Health Coverage: 2017 Global Monitoring Report Tracking universal health coverage: 2017 global monitoring report ISBN 978-92-4-151355-5 © World Health Organization and the International Bank for Reconstruction and Development / The World Bank 2017 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https:// creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO or The World Bank endorse any specic organization, products or services. The use of the WHO logo or The World Bank logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO) or The World Bank. WHO and The World Bank are not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization.
    [Show full text]
  • 21St-Century Capitalism: Structural Challenges for Universal Health Care Susan K
    Sell Globalization and Health 2019, 15(Suppl 1):76 https://doi.org/10.1186/s12992-019-0517-3 COMMENTARY Open Access 21st-century capitalism: structural challenges for universal health care Susan K. Sell From The Political Origins of Health Inequities and Universal Health Coverage Oslo, Norway. 01-02 November 2018 Abstract The structural perspective outlined here sheds light on some of the fundamental challenges involved in achieving Universal Health Care (UHC) in this twenty-first-century era of trade and financialized capitalism. This commentary explores connections between the structure of twenty-first-century capitalism and challenges to achieving UHC, discussing three features of today’s capitalism: financialized capitalism; trade, intangibles and global value chains; and inequality (as exacerbated by the first two features). The final section discusses the various opportunities for reform to facilitate UHC—from tinkering with the status quo, to deeper regulatory reform and fundamental structural change. Keywords: Financialized capitalism, Global supply chains, Inequality, Intellectual property Background leaders, and representatives (including trade unions)” ([6], This commentary presents several features of twenty-first- p.S40). While some countries have made considerable century capitalism, highlighting some of the challenges it progress towards achieving UHC [1, 7], the long-standing poses for achieving universal health care (UHC), or access quest to achieve UHC faces new challenges in the era of for all to appropriate health services without financial twenty-first-century capitalism. hardship [1]. The World Health Organization, the United This commentary explores some of the connections Nations and many civil society organizations have pro- between the structure of twenty-first-century capitalism moted UHC as an organizing principle for national health and challenges to achieving UHC, focusing on three fea- systems [2].
    [Show full text]
  • Reforming the Delivery of Public Dental Services in Ireland: Potential Cost Implications
    RESEARCH SERIES NUMBER 80 REFORMING THE DELIVERY OF PUBLIC April 2019 DENTAL SERVICES IN IRELAND POTENTIAL COST IMPLICATIONS ANNE NOLAN FO NCE R PO DE LI VI C E Y REFORMING THE DELIVERY OF PUBLIC DENTAL SERVICES IN IRELAND: POTENTIAL COST IMPLICATIONS Anne Nolan April 2019 RESEARCH SERIES NUMBER 80 Available to download from www.esri.ie The Economic and Social Research Institute Whitaker Square, Sir John Rogerson’s Quay, Dublin 2 ISBN 978-0-7070-0471-6 DOI https://doi.org/10.26504/rs80 This Open Access work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. ABOUT THE ESRI The mission of the Economic and Social Research Institute is to advance evidence- based policymaking that supports economic sustainability and social progress in Ireland. ESRI researchers apply the highest standards of academic excellence to challenges facing policymakers, focusing on 12 areas of critical importance to 21st Century Ireland. The Institute was founded in 1960 by a group of senior civil servants led by Dr T.K. Whitaker, who identified the need for independent and in-depth research analysis to provide a robust evidence base for policymaking in Ireland. Since then, the Institute has remained committed to independent research and its work is free of any expressed ideology or political position. The Institute publishes all research reaching the appropriate academic standard, irrespective of its findings or who funds the research. The quality of its research output is guaranteed by a rigorous peer review process.
    [Show full text]
  • A Systematic Review of Human Resources for Health Management
    Obermann et al. Health Economics Review (2018) 8:4 https://doi.org/10.1186/s13561-018-0188-4 REVIEW Open Access The shaded side of the UHC cube: a systematic review of human resources for health management and administration in social health protection schemes Konrad Obermann1* , Tata Chanturidze2, Bernd Glazinski3, Karin Dobberschuetz4, Heiko Steinhauer1 and Jean-Olivier Schmidt5 Abstract Managers and administrators in charge of social protection and health financing, service purchasing and provision play a crucial role in harnessing the potential advantage of prudent organization, management and purchasing of health services, thereby supporting the attainment of Universal Health Coverage. However, very little is known about the needed quantity and quality of such staff, in particular when it comes to those institutions managing mandatory health insurance schemes and purchasing services. As many health care systems in low- and middle-income countries move towards independent institutions (both purchasers and providers) there is a clear need to have good data on staff and administrative cost in different social health protection schemes as a basis for investing in the development of a cadre of health managers and administrators for such schemes. We report on a systematic literature review of human resources in health management and administration in social protection schemes and suggest some aspects in moving research, practical applications and the policy debate forward. Keywords: Human resources, Health financing, Health administration, Health care purchasing, Management, UHC JEL classification: I11, I13, J24, J45 Introduction medical staff to deliver such care. The importance of The health workforce has received major policy atten- strategic purchasing for improving health sector out- tion over the past decade, not least by the Millennium comes and efficiency has been recently highlighted in a Development Goals (MDGs) and now the Sustainable number of studies [21].
    [Show full text]