Match!

Defining a Health Benefits Package: What Are the Necessary Processes?

Published on Jan 2, 2016in Health Systems and Reform
· DOI :10.1080/23288604.2016.1124171
Amanda Glassman19
Estimated H-index: 19
(CGD: Center for Global Development),
Ursula Giedion11
Estimated H-index: 11
(BID: Inter-American Development Bank)
+ 1 AuthorsPeter C. Smith58
Estimated H-index: 58
(Imperial College London)
Abstract
Abstract—There is immense interest worldwide in the notion of universal health coverage (UHC). A major policy focus in moving toward UHC has been on the key policy question: what services should be made available and under what conditions? In this article we are concerned with how a feasible set of UHC services can be explicitly defined to create what is commonly known as a “health benefits package” (HBP), a set of services that can be feasibly financed and provided under the actual circumstances in which a given country finds itself. We explain why an explicit statement of the HBP is important and then describe a framework that includes ten core elements that are indispensable if a coherent and sustainable process for setting the HBP is to be established.
  • References (28)
  • Citations (20)
📖 Papers frequently viewed together
31 Citations
3 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References28
Newest
El Plan de Beneficios de Salud (PBS) de Colombia, conocido como Plan Obligatorio de Salud (POS), fue adoptado en 1993. Actualmente cubre al 90% de la poblacion y se consolida como uno de los planes con mas trayectoria en el contexto de America Latina. El presente documento expone la historia del PBS colombiano, sus principales caracteristicas y los desafios a los que se enfrenta en el marco de los recientes cambios del sistema de salud de Colombia.
1 CitationsSource
#1Daniel CotlearH-Index: 1
#2Somil NagpalH-Index: 1
Last. Rafael CortezH-Index: 1
view all 5 authors...
This book is based on systematic data collection among 26 universal health coverage (UHC) programs across 24 countries in the UHC studies. The main objective of this report is to document and analyze the experiences of 24 countries based on a systematic data collection that sought to capture in great detail how they are doing so. Thus the book aims to extend, on number of countries covered and detail of information collected the large number of case studies that have already enriched the global ...
47 Citations
#1John Hudson (University of Bath)H-Index: 26
We conclude that individual aid sector volatility matters as well as total aid volatility. Easily, the most important contributor to total volatility is debt aid. The most volatile aid sectors per se include debt, industry, and humanitarian, and the least include education and health. In several sectors volatility appears to have peaked around 2006. Within individual countries, sector volatility is often corrected for in the following period, there are also sometimes knock-on effects on other se...
15 CitationsSource
Progress towards universal health coverage involves providing people with access to needed health services without entailing financial hardship and is often advocated on the grounds that it improves population health. The paper offers econometric evidence on the effects of health coverage on mortality outcomes at the national level. We use a large panel data set of countries, examined by using instrumental variable specifications that explicitly allow for potential reverse causality and unobserv...
34 CitationsSource
Last. Michael Drummond (Ebor: University of York)H-Index: 72
view all 10 authors...
Background: Differential pricing, based on countries’ purchasing power, is recommended by the WHO to secure affordable medicines. However, in developing countries innovative drugs often have similar or even higher prices than in high-income countries. We evaluated the potential implications of trastuzumab global pricing policies in terms of cost-effectiveness (CE), coverage and accessibility for patients with breast cancer in Latin America (LA). Methods: A Markov model was designed to estimate l...
12 CitationsSource
#1Ursula GiedionH-Index: 11
#2Ignez TristaoH-Index: 2
Last. Luis Bolaño PradoH-Index: 2
view all 18 authors...
Guaranteeing the right to health care under equal conditions for all is a goal that every society desires to achieve, particularly in a region as unequal as Latin America and the Caribbean. Universal coverage is an important objective for most countries; however, the context for attaining universal coverage is difficult, as the pressure on health spending mounts with each passing day. So, what to leave in or out of a health benefit plan?
9 Citations
#1Ricardo Bitran (World Bank)H-Index: 1
The aim of the report is to review existing approaches and available policy options to improve access to health care services and financial protection against health shocks for informal-sector workers (ISWs). Along with their families, ISWs represent the majority of the population in many developing countries. The report reviews the definition and measurement of the informal sector and the literature on efforts toward its health insurance coverage. It also examines several country cases based on...
13 Citations
#2Trygve OttersenH-Index: 9
Last. Alicia Ely YaminH-Index: 21
view all 22 authors...
90 Citations
#1Dean T. Jamison (UW: University of Washington)H-Index: 50
#2Lawrence H. Suimners (Harvard University)H-Index: 86
Last. Gavin Yamey (UCSF: University of California, San Francisco)H-Index: 22
view all 25 authors...
Prompted by the 20th anniversary of the 1993 World Development Report a Lancet Commission revisited the case for investment in health and developed a new investment frame work to achieve dramatic health gains by 2035. The report has four key messages each accompanied by opportunities for action by national governments of low-income and middle-income countries and by the international community. Conclusion 1: there is a very large payoff from investing in health. Conclusion 2: a grand convergence...
620 CitationsSource
#1Ursula GiedionH-Index: 11
Last. Yadira DiazH-Index: 6
view all 3 authors...
The document is organized as follows. Chapter two provides an introduction to the conceptual framework guiding this study. It is organized in three sections. First, it discusses the concept of universal coverage and the health schemes and programs the concept refers to. Second, it discusses the causal link between universal coverage schemes and health-related outcome indicators. Third, it presents key methodological challenges faced by analysts wishing to evaluate the impact of Universal Health ...
83 Citations
Cited By20
Newest
#1Matthias ArnoldH-Index: 2
#2Dominic Nkhoma (UNIMA: University of Malawi)H-Index: 3
Last. Susan GriffinH-Index: 24
view all 3 authors...
In low- and middle-income countries (LMICs), making the best use of scarce resources is essential to achieving universal health coverage. The design of health benefits packages creates the opportunity to select interventions on the basis of explicit objectives. Distributional cost-effectiveness analysis (DCEA) provides a framework to evaluate interventions based on two objectives: increasing population health, and reducing health inequality. We conduct aggregate DCEA of potential health benefits...
Source
#1Ashley A. LeechH-Index: 3
#2David D. Kim (Tufts Medical Center)H-Index: 11
Last. Peter J. Neumann (Tufts Medical Center)H-Index: 81
view all 4 authors...
Introduction Since resources are finite, investing in services that produce the highest health gain ‘return on investment’ is critical. We assessed the extent to which low and middle-income countries (LMIC) have included cost-saving interventions in their national strategic health plans. Methods We used the Tufts Medical Center Global Health Cost-Effectiveness Analysis Registry, an open-source database of English-language cost-per-disability-adjusted life year (DALY) studies, to identify analyse...
Source
#1Rahab Mbau (Wellcome Trust)H-Index: 2
#2Evelyn Kabia (Wellcome Trust)H-Index: 2
Last. Edwine Barasa (University of Oxford)H-Index: 12
view all 5 authors...
Kenya has prioritized the attainment of universal health coverage (UHC) through the expansion of health insurance coverage by the National Hospital Insurance Fund (NHIF). In 2015, the NHIF introduced reforms in premium contribution rates, benefit packages, and provider payment methods. We examined the influence of these reforms on NHIF’s purchasing practices and their implications for strategic purchasing and health system goals of equity, efficiency and quality. We conducted an embedded case st...
Source
#1James Love-KohH-Index: 2
#2Susan GriffinH-Index: 24
Last. Simon WalkerH-Index: 27
view all 6 authors...
Unfair differences in healthcare access, utilisation, quality or health outcomes exist between and within countries around the world. Improving health equity is a stated objective for many governments and international organizations. We provide an overview of the major tools that have been developed to measure, evaluate and promote health equity, along with the data required to operationalise them. Methods are organised into four key policy questions facing decision-makers: (i) what is the curre...
Source
There is widespread and growing interest in designing and implementing social health insurance schemes (SHIS) across many low- and middle-income countries as a means to improve financial protection and achieve universal health coverage. SHIS recently gained traction in Nigeria, but evidence regarding optimal design features of SHIS is sparse and there is lack of a simple and standardised checklist that scheme designers, implementers and researchers could use to assess, guide and inform the desig...
Source
#1Mohammad Javad Kabir (Golestan University)H-Index: 3
#2Alireza Heidari (Golestan University)H-Index: 3
Last. Seyed-Kamalaldin Mirkarim (Golestan University)
view all 6 authors...
ABSTRACTBackground: Basic health services package (BHSP) is one of the key strategies for improving the effectiveness of health systems and equitable distribution of resources.Required factors to s...
Source
Myanmar’s health sector has received low levels of public spending since 1975. Combined with the country’s historic political and economic isolation, poor economic management and multiple internal armed conflicts, these limited resources have translated into low coverage of even the most basic services and into poor health outcomes with wide disparities. They have also resulted in out-of-pocket payments for health as a proportion of total health spending being among the highest in the world. The...
Source
Background Evidence-informed deliberative processes (EDPs) were recently introduced to guide health technology assessment (HTA) agencies to improve their processes towards more legitimate decision-making. The EDP framework provides guidance that covers the HTA process, ie, contextual factors, installation of an appraisal committee, selecting health technologies and criteria, assessment, appraisal, and communication and appeal. The aims of this study were to identify the level of use of EDPs by H...
Source
#1Ramin Hayati (Shiraz University of Medical Sciences)H-Index: 2
#2Mohammad Javad Kabir (Golestan University)H-Index: 3
view all 6 authors...
Objectives This study has analyzed the policy-making requirements related to basic health insurance package at the national level with a systematic view.
Source
Source