卫生系统对肾脏护理的监督和筹资的全球概述

IF 19.3 2区 医学 Q1 UROLOGY & NEPHROLOGY
Aminu K. Bello , Mona Alrukhaimi , Gloria E. Ashuntantang , Ezequiel Bellorin-Font , Mohammed Benghanem Gharbi , Branko Braam , John Feehally , David C. Harris , Vivekanand Jha , Kailash Jindal , David W. Johnson , Kamyar Kalantar-Zadeh , Rumeyza Kazancioglu , Peter G. Kerr , Meaghan Lunney , Timothy Olusegun Olanrewaju , Mohamed A. Osman , Jeffrey Perl , Harun Ur Rashid , Ahmed Rateb , Adeera Levin
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引用次数: 37

摘要

可靠的治理和卫生筹资对于不同国家卫生系统持续满足其人民(包括肾病患者)卫生需求的能力至关重要。因此,有必要全面了解现有的系统和基础设施,以便在全球范围内确定肾脏护理方面的差距,并优先考虑需要改进的领域。这项跨国横断面调查是由ISN作为全球肾脏健康地图集的一部分进行的,调查了世界各地肾脏护理基础设施的监督、融资和感知质量。总体而言,125个国家(占世界人口的93%)对整个调查做出了回应,其中122个国家回答了与该领域有关的问题。国家对肾脏护理的监督在高收入国家最为常见,而个别医院的监督在低收入国家最为常见。非洲和中东部分地区似乎没有有组织的监督制度。在AKI(56%)、非透析慢性肾病(40%)、透析(63%)和肾移植(57%)等方面,卫生保健系统对肾病患者实行公费和免费覆盖的国家所占比例各不相同,但在低收入国家,特别是非洲和东南亚,这一比例要低得多,因为这些国家更多地依赖私人资助,患者的自付费用更多。肾脏疾病的早期发现和管理最不可能被资助模式所涵盖。在所有高收入国家中,支持急性肾损伤和慢性肾脏疾病治疗的卫生基础设施的感知质量被评为差至极差,但在40%以上的低收入国家,特别是非洲,被评为差至极差。这项研究表明,特别是在低收入和中等收入国家,在支持照顾肾病患者的卫生服务的监督、资金和基础设施方面存在重大差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Global overview of health systems oversight and financing for kidney care

Global overview of health systems oversight and financing for kidney care

Global overview of health systems oversight and financing for kidney care

Global overview of health systems oversight and financing for kidney care

Reliable governance and health financing are critical to the abilities of health systems in different countries to sustainably meet the health needs of their peoples, including those with kidney disease. A comprehensive understanding of existing systems and infrastructure is therefore necessary to globally identify gaps in kidney care and prioritize areas for improvement. This multinational, cross-sectional survey, conducted by the ISN as part of the Global Kidney Health Atlas, examined the oversight, financing, and perceived quality of infrastructure for kidney care across the world. Overall, 125 countries, comprising 93% of the world’s population, responded to the entire survey, with 122 countries responding to questions pertaining to this domain. National oversight of kidney care was most common in high-income countries while individual hospital oversight was most common in low-income countries. Parts of Africa and the Middle East appeared to have no organized oversight system. The proportion of countries in which health care system coverage for people with kidney disease was publicly funded and free varied for AKI (56%), nondialysis chronic kidney disease (40%), dialysis (63%), and kidney transplantation (57%), but was much less common in lower income countries, particularly Africa and Southeast Asia, which relied more heavily on private funding with out-of-pocket expenses for patients. Early detection and management of kidney disease were least likely to be covered by funding models. The perceived quality of health infrastructure supporting AKI and chronic kidney disease care was rated poor to extremely poor in none of the high-income countries but was rated poor to extremely poor in over 40% of low-income countries, particularly Africa. This study demonstrated significant gaps in oversight, funding, and infrastructure supporting health services caring for patients with kidney disease, especially in low- and middle-income countries.

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来源期刊
Kidney International Supplements
Kidney International Supplements UROLOGY & NEPHROLOGY-
CiteScore
11.80
自引率
0.00%
发文量
13
期刊介绍: Kidney International Supplements is published on behalf of the International Society of Nephrology (ISN) and comes complimentary as part of a subscription to Kidney International. Kidney International Supplements is a peer-reviewed journal whose focus is sponsored, topical content of interest to the nephrology community.
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