摩洛哥的全民医保:基于成本核算数据库的公立医院筹资规模自下而上的估算。

IF 2.7 3区 经济学 Q1 ECONOMICS
El Houcine Akhnif, Abdelouahab Belmadani, Awad Mataria, Maryam Bigdeli
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引用次数: 0

摘要

背景:摩洛哥正在进行医疗系统改革,目标是到 2025 年在全国人口中普及医疗保险。本研究旨在建立摩洛哥各级公立医院的全国成本数据库,并将该数据库作为战略采购系统的进一步使用资源。本研究还旨在估算摩洛哥公立医院在当前雄心勃勃的改革中充分发挥作用所需的资金缺口和预算:对摩洛哥 12 个地区的 39 家医院(10 家省级医院、11 家地区医院和 18 家教学医院)进行了成本核算研究。利用医院成本计算方法,我们在全国范围内调整并验证了我们的方法,根据 2019 年的数据生成了单位成本数据库。我们从各个角度考虑了成本问题。数据收集工作由卫生部干部负责,世界卫生组织驻摩洛哥国家办事处提供了协助。成本数据库的建立有助于自下而上地估算公立医疗医院的筹资规模:结果:研究表明,在摩洛哥进行大规模成本计算是可行的。卫生部的自主性和对程序的遵守确保了所收集数据的高质量。从一家医院到另一家医院,相同服务的单位成本存在很大差异,这表明存在效率低下的问题。该数据库将有助于在普遍医疗保险计划内形成战略性采购机制。所研究的医院可作为系统更新医疗保险计费系统的参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
UHC in Morocco: a bottom-up estimation of public hospitals' financing size based on a costing database.

Background: Morocco is engaged in a health system reform aimed at generalizing health insurance across the whole population by 2025. This study aims to build a national database of costs at all levels of public hospitals in Morocco and craft this database as a resource for further use in a strategic purchasing system. It also aims at estimating the funding gap and the budget that should be secured for public hospitals in Morocco to fully play their roles in the current ambitious reform.

Method: A costing study was implemented in 39 hospitals in 12 regions of Morocco (10 provincial hospitals, 11 regional hospitals, and 18 teaching hospitals). Using the hospital costing approach, we adapted and validated nationally our methodology to generate a database of unit costs based on data from 2019. All perspectives on cost were considered. Data collection was performed by cadres from MoH and facilitated by the WHO country office in Morocco. The production of the cost database allowed the development of a bottom-up estimation of the financing size for public health hospitals.

Results: The study showed the feasibility of large-scale costing in the context of Morocco. The ownership of MoH and adherence to the process ensured the high quality of the collected data. There are many differences in unit costs for the same services moving from one hospital to another, which indicates existing inefficiencies. The database will contribute to shaping the strategic purchasing mechanism within the generalized health insurance schemes. The studied hospitals could be used as references to systematically update the billing system for health insurance.

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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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