 Design, implementation, and evaluation of a community financing scheme for hospital care in developing countries: A pre-paid health plan in the Bwamanda health zone, ZaireFreddy Moens Social Science & Medicine, 1990, vol. 30, issue 12, 1319-1327 Abstract: Unless scarce resources can be mobilized and used efficiently, health for all by the year 2000 will remain a vain attempt. Innovative financing schemes exploring increased cost recovery from the users of the health system are explored throughout the world. In Bwamanda, Zaire, a community financing scheme for hospital care was developed through the application of operations research. A preference heuristic with considerable involvement of health providers and the community was used to identify the type of financing scheme and resulted in a pre-paid health plan, while a mathematical model was developed to determine the premiums to charge. The implementation of the health plant is briefly described. An evaluation of the effects of the pre-paid plan on the accessibility and equity of health care, as well as on the financial sustainability of the hospital, is presented and discussed: a steadily increasing membership of the health plan illustrates its appropriateness, while a doubling of the cost recovery of the hospital's operating costs after two years seems promising; the hospitalization rate of members of the health plan was significantly higher than for non-members. These findings suggest that a health zone may be an appropriate level for the organization of a regional pre-paid health plan. Problems of equity, full cost recovery, and replicability of the financing scheme are discussed. Keywords: pre-paid; health; plan; health; care; financing; developing; countries; Zaire; community; financing; evaluation; operations; research (search for similar items in EconPapers) Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:eee:socmed:v:30:y:1990:i:12:p:1319-1327 Ordering information: This journal article can be ordered from Access Statistics for this article Social Science & Medicine is currently edited by Ichiro (I.) Kawachi and S.V. (S.V.) Subramanian More articles in Social Science & Medicine from Elsevier |
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