پديد آورندگان :
سعادتي، محمد دانشگاه علوم پزشكي تبريز , رضاپور، رامين دانشگاه علوم پزشكي تبريز - دانشكده مديريت و اطلاع رساني پزشكي , درخشاني، ناصر دانشگاه علوم پزشكي تبريز - دانشكده مديريت و اطلاع رساني پزشكي , نقشي، مريم دانشگاه علوم پزشكي تبريز - دانشكده مديريت و اطلاع رساني پزشكي
كليدواژه :
عدالت , بيمه سلامت , تامين مالي , مشاركت عادلانه
چكيده فارسي :
مقدمه: مشاركت عادلانه در تامين مالي يكي از اهداف اصلي نظام هاي بهداشتي درماني در جهان مي باشد. برقراري سيستم بيمه اي يكي از رايج ترين روش ها براي محافظت مالي مردم در برابر هزينه هاي سلامتي به شمار مي رود. لذا مطالعه حاضر با هدف بررسي تطبيقي نظام هاي بيمه اي در كشورهاي مختلف جهان صورت گرفت. روش پژوهش: اين پژوهش به صورت تطبيقي در سال ۱۳۹۵ انجام گرفت. ابتدا بررسي متون جامعي براي استخراج شواهد علمي با استفاده از پايگاه هاي داده و وبسايت هاي مرتبط و معتبر انجام پذيرفت. پس از غربالگري متون يافته شده، داده هاي مربوط
به شاخص هاي عدالت در تامين مالي استخراج گرديد. جهت تطبيق داده هاي شاخص هاي عدالت در تامين مالي با مدل هاي بيمه سلامت از چارچوب تقسيم بندي گاردن استفاده شد. يافته ها: دركشورهاي مورد مطالعه از چهار مدل تامين مالي و بيمه اي كه شامل بيمه درمان ملي (NHI)، سيستم طب ملي (NHS)، بيمه درمان اجتماعي (SHI) و بيمه خصوصي استفاده مي شد. فرانسه و استراليا كشورهايي بودند كه از دو مدل به طور همزمان استفاده مي كنند. كشورهاي انگليس، دانمارك، كانادا و آلمان به ترتيب داراي بالاترين ميزان شاخص مشاركت عادلانه در تامين مالي بودند.
نتيجه گيري: يافته هاي مطالعه نشان داد سيستم هاي بيمه اي اجتماعي، بيمه هاي ملي و سيستم ملي بهداشتي مي توانند عملكرد مناسبي در محافظت مالي افراد جامعه نشان دهند، بنابراين مي توان گفت برقراري سيستم بيمه اي نقش بسزايي در محافظت مالي مردم در برابر هزينه اي سلامت داشته است. البته قابل ذكر است انتخاب مدل بيمه اي در كشورها بايد براساس منابع و زير ساخت هاي موجود هر كشور صورت پذيرد تا بتواند بخوبي نقش خود را ايفا كند.
چكيده لاتين :
Introduction: Fair financing contribution is one of the main objectives the healthcare systems in the world. Insurance system is one of the most common methods of financial protection against the cost of healthy people is considered. This study aimed to evaluate the comparative insurance system in different countries were performed. Methods: This comparative study was conducted in 2017. First, a comprehensive literature search was conducted through relevant and valid databases and websites to extract scientific evidence. After the screening of findings, Data related to the fairness financing, including the out of pocket, catastrophic payment and fair financing contribution was extracted. Garden classification framework used to match the indicators with models of health insurance. Results: In countries studied, four model finance and insurance including: national health insurance (NHI), national medical system (NHS), social health insurance (SHI) and private insurance was used. France and Australia are the countries where the two models are used simultaneously. The lowest rate of pay out of pocket and catastrophic health expenditure for households in France (6 and 0.01 percent), which uses public and private health insurance model. Britain, Denmark, Canada and Germany, respectively, have the highest indices were fair participation in financing. Conclusion: According to the study it can be concluded that social insurance, national insurance and national health systems can have a good performance in financial protection of the population, So can say insurance system establishing a significant role in financial protection against the cost of people's health. Of course is to be mentioned for choose the model insurance countries should be based on infrastructure and resources available in every country so well able to play its role. Introduction: Fair financing contribution is one of the main objectives the healthcare systems in the world. Insurance system is one of the most common methods of financial protection against the cost of healthy people is considered. This study aimed to evaluate the comparative insurance system in different countries were performed.Method: This comparative study was conducted in 2017. First, a comprehensive literature search was conducted through relevant and valid databases and websites to extract scientific evidence. After the screening of findings, Data related to the fairness financing was extracted. Garden classification framework used to match the indicators with models of health insurance.Result:In countries studied, four model finance and insurance including: national health insurance (NHI), national medical system (NHS), social health insurance (SHI) and private insurance was used. The lowest rate of pay out of pocket and catastrophic health expenditure for households in France (6 and 0.01 percent), which uses public and private health insurance model. Britain, Denmark, Canada and Germany, respectively, have the highest indices were fair participation in financing.Conclusion: According to the study it can be concluded that social insurance, national insurance and national health systems can have a good performance in financial protection of the population, So can say insurance system establishing a significant role in financial protection against the cost of people's health. Of course is to be mentioned for choose the model insurance countries should be based on infrastructure and resources available in every country so well able to play its role.
