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Strategic Health Purchasing Progress Mapping: A Spotlight on Ghana’s National Health Insurance Scheme 战略医疗采购进展地图:加纳国家医疗保险计划的焦点
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2058337
E. Amporfu, P. Agyei-Baffour, A. Edusei, J. Novignon, Eric Arthur
ABSTRACT Ghana is a lower-middle-income economy that has made significant efforts to improve its health system, in order to achieve universal health coverage. Ghana has adopted strategic health purchasing as an important tool for efficient utilization of resources. This paper focuses on Ghana’s National Health Insurance Scheme (NHIS) analyzing its governance arrangements and purchasing functions; and providing recommendations for improvement. The study applied the Strategic Health Purchasing Progress Tracking Framework co-created by the Strategic Purchasing Africa Resource Center (SPARC) and its partners to collect data from secondary and primary sources between September 2019 and June 2020. A descriptive and narrative approach was used to synthesize information on the NHIS governance arrangements and purchasing functions based on the framework. Benchmarks were used to describe the NHIS on the continuum from passive to strategic purchasing and to identify steps to make purchasing more strategic. Strengths and weaknesses were found in governance and purchasing functions. Progress was seen in how the NHIS selects the services in the benefit package, regularly reviewing the package to respond to the health needs of the population, and in how it selectively contracts with providers, particularly private providers, to ensure that standards for quality of care are met. However, challenges remain in performance monitoring, due to claims being mostly processed manually, and provider payment, due to frequent unbundling and upcoding of services Ghana has made significant strides toward the achievement of universal health coverage, but there is room for improvement in provider payment and performance monitoring. Video Abstract Read the transcript Lire la transcription Watch the video on Vimeo © 2022 The Author(s). Published with license by Taylor&Francis Group, LLC
加纳是一个中低收入经济体,为实现全民健康覆盖,加纳在改善卫生系统方面做出了重大努力。加纳将战略性医疗采购作为有效利用资源的重要工具。本文重点分析了加纳国家健康保险计划(NHIS)的治理安排和采购功能;并提供改进建议。该研究应用了由非洲战略采购资源中心(SPARC)及其合作伙伴共同创建的战略卫生采购进度跟踪框架,从2019年9月至2020年6月期间从二级和一级来源收集数据。采用描述性和叙述性的方法综合了基于框架的NHIS治理安排和采购功能的信息。使用基准来描述NHIS从被动采购到战略采购的连续体,并确定使采购更具战略性的步骤。在治理和采购功能中发现了优势和劣势。在国家卫生保健系统如何选择一揽子福利中的服务,定期审查一揽子福利以满足人口的保健需求,以及如何有选择地与提供者,特别是私营提供者签订合同,以确保满足护理质量标准方面取得了进展。然而,在绩效监测方面仍然存在挑战,因为索赔大多是手工处理的,而在提供商支付方面,由于服务频繁分拆和升级,加纳在实现全民健康覆盖方面取得了重大进展,但在提供商支付和绩效监测方面仍有改进的空间。视频摘要阅读转录现场转录观看视频在Vimeo©2022作者(s)。由泰勒和弗朗西斯集团有限责任公司授权出版
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引用次数: 9
Strategic Health Purchasing in Nigeria: Investigating Governance and Institutional Capacities within Federal Tax-Funded Health Schemes and the Formal Sector Social Health Insurance Programme 尼日利亚的战略性医疗采购:调查联邦税收资助的医疗计划和正规部门社会医疗保险方案中的治理和机构能力
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2074630
U. Ezenwaka, A. Gatome-Munyua, Chikezie Nwankwor, Nkechi Olalere, Nneka Orji, Uchenna Ewelike, B. Uzochukwu, O. Onwujekwe
ABSTRACT For Nigeria to make progress on its commitment to universal health coverage, additional public funding will be required. But more resources alone will not be enough. Government health spending must be more efficient and effective, through more strategic purchasing—a critical policy tool. Studies on health purchasing in Nigeria’s health financing schemes are limited, however. This study examines the purchasing arrangements in schemes funded by the federal budget and in the Formal Sector Social Health Insurance Programme (FSSHIP) within the National Health Insurance Scheme. We adopted a qualitative, descriptive case-study approach and collected data through document reviews and key informant interviews based on the Strategic Health Purchasing Progress Tracking Framework. Our analysis used a thematic framework approach. Our findings reveal that legal frameworks and governance structures for strategic purchasing are in place for both schemes. Steps toward strategic purchasing are more advanced in FSSHIP, particularly in the design of benefit packages, accreditation and monitoring of health maintenance organizations (HMOs) and providers, and provider payment mechanisms. The limited share of health funding flowing through these mechanisms, and further fragmentation of that funding, impede strategic purchasing. Strategic purchasing is also hampered by weak regulation and monitoring of providers and purchasers, delays in provider payment, and corrupt practices by HMOs. Improving strategic purchasing in Nigeria will require a concerted effort to reduce fragmentation of health spending, significant investment in human resources, technical know-how, and information systems of purchasing institutions, and actions to improve the accountability of all actors in the system. Video Abstract Read the transcript Lire la transcription Watch the video on Vimeo © 2022 The Author(s). Published with license by Taylor&Francis Group, LLC
尼日利亚要在其全民健康覆盖承诺方面取得进展,将需要额外的公共资金。但是仅仅增加资源是不够的。政府的卫生支出必须通过更具战略性的采购——一个关键的政策工具——来提高效率和效果。然而,关于尼日利亚卫生筹资计划中医疗采购的研究有限。这项研究审查了联邦预算资助的计划和国家健康保险计划内的正式部门社会健康保险方案(FSSHIP)的采购安排。我们采用定性、描述性案例研究方法,并根据战略卫生采购进度跟踪框架,通过文件审查和关键信息提供者访谈收集数据。我们的分析使用了主题框架方法。我们的研究结果表明,战略采购的法律框架和治理结构都适用于这两种方案。FSSHIP的战略采购步骤更为先进,特别是在福利方案的设计、对健康维护组织(hmo)和提供者的认证和监测以及提供者支付机制方面。通过这些机制流动的卫生资金份额有限,而且资金进一步分散,阻碍了战略采购。对提供者和购买者的监管和监督不力、提供者付款延迟以及卫生保健组织的腐败行为也阻碍了战略采购。改善尼日利亚的战略采购将需要共同努力减少卫生支出的分散,对人力资源、技术诀窍和采购机构的信息系统进行大量投资,并采取行动改善系统中所有行为者的问责制。视频摘要阅读转录现场转录观看视频在Vimeo©2022作者(s)。由泰勒和弗朗西斯集团有限责任公司授权出版
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引用次数: 5
Strengths and Weaknesses of Strategic Health Purchasing for Universal Health Coverage in Rwanda 卢旺达全民健康覆盖战略卫生采购的优势和劣势
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-03-01 DOI: 10.1080/23288604.2022.2061891
Stella M Umuhoza, S. Musange, Alypio Nyandwi, A. Gatome-Munyua, A. Mumararungu, R. Hitimana, Alexis Rulisa, P. Uwaliraye
ABSTRACT In the context of scarce resources and increasing health care costs, strategic purchasing is viewed as a key mechanism to spur countries’ progress toward universal health coverage (UHC), by using limited resources more effectively. We applied the Strategic Health Purchasing Progress Tracking Framework to examine the health purchasing arrangements in three health financing schemes in Rwanda—the Community Based Health Insurance (CBHI) scheme, the Rwanda Social Security Board (RSSB) medical scheme, and performance-based financing (PBF). Data were collected from secondary and primary sources between September 2020 and March 2021.The objective of the study was to identify areas of progress in strategic purchasing that can be built on, and to identify areas of overlap, duplication, or conflict that limit progress in strategic purchasing to advance UHC goals. This study found that Rwanda has made progress in many areas of strategic purchasing and has a strong foundation for building further. However, some overlaps and duplication of functions weaken the power of purchasers to improve resource allocation, incentives for providers, and accountability. In addition, some of the policies within the purchasing functions could be made more strategic. In particular, open-ended fee-for-service payment in the CBHI scheme not only threatens the scheme’s financial sustainability but also imposes a high administrative burden. Better alignment and integration of contracting, incentives, and information system design to provide timely and relevant information for purchasing decisions would contribute to more strategic health purchasing and ensure that Rwanda’s health sector achievements are sustained and expanded.
在资源稀缺和卫生保健成本不断增加的背景下,战略采购被视为通过更有效地利用有限资源来促进各国向全民健康覆盖(UHC)迈进的关键机制。我们应用战略卫生采购进度跟踪框架来检查卢旺达三个卫生融资计划中的卫生采购安排——基于社区的健康保险(chi)计划、卢旺达社会安全委员会(RSSB)医疗计划和基于绩效的融资(PBF)。数据于2020年9月至2021年3月期间从二手和一手来源收集。该研究的目的是确定可以在战略采购方面取得进展的领域,并确定重叠、重复或冲突的领域,这些领域限制了战略采购推进全民健康覆盖目标的进展。这项研究发现,卢旺达在战略采购的许多领域取得了进展,并具有进一步发展的坚实基础。然而,一些职能的重叠和重复削弱了购买者改善资源分配、激励提供者和问责制的权力。此外,采购职能内的一些政策可以更具战略性。特别是,CBHI计划中无限制的按服务收费不仅威胁到该计划的财务可持续性,而且还造成了很高的行政负担。更好地协调和整合合同、激励措施和信息系统设计,为采购决策提供及时和相关的信息,将有助于更具战略性的卫生采购,并确保卢旺达卫生部门的成就得以持续和扩大。
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引用次数: 5
Commercial and Social Value of Pharmaceutical Industry-led Access Programs: Conceptual Framework and Descriptive Analysis 制药行业主导的准入计划的商业和社会价值:概念框架和描述性分析
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1080/23288604.2022.2057831
Joshua Smith-Sreen, A. C. Heerdegen, V. Wirtz, Priyanka Kulkarni, Melissa Machado, P. Rockers
ABSTRACT Pharmaceutical industry-led access programs are growing in number globally and are increasingly adopting a hybrid approach intended to generate commercial and social value in parallel. We developed and applied a new conceptual framework in a descriptive analysis of observable indicators measuring commercial and social value for 91 programs registered in the Access Observatory. We found that most programs had features consistent with the generation of commercial value, directly through revenue generation (50.0%), or indirectly by creating competitive advantage (70.3%). We also found that most programs were implemented in countries where the company has commercial products registered (85.5%). While many programs had features consistent with the generation of social value, it was difficult to ascertain the level of that value because most did not share data (83.5%) and had not been evaluated (74.7%). Future efforts by the global health community and the pharmaceutical industry should focus on strengthening measurement and reporting on commercial and social indicators of industry-led access programs.
制药行业主导的可及性项目在全球范围内数量不断增长,并且越来越多地采用旨在同时产生商业和社会价值的混合方法。我们开发并应用了一个新的概念框架,对在访问观察站注册的91个项目的商业和社会价值衡量指标进行了描述性分析。我们发现,大多数项目具有与商业价值的产生相一致的特征,直接通过创收(50.0%),或间接通过创造竞争优势(70.3%)。我们还发现,大多数项目是在公司有商业产品注册的国家实施的(85.5%)。虽然许多项目具有与社会价值产生相一致的特征,但由于大多数项目没有共享数据(83.5%)和没有进行评估(74.7%),因此很难确定该价值的水平。全球卫生界和制药行业今后的努力应侧重于加强对行业主导的可及性项目的商业和社会指标的测量和报告。
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引用次数: 1
Integrating Venezuelan Migrants into the Colombian Health System during COVID-19 在2019冠状病毒病期间将委内瑞拉移民纳入哥伦比亚卫生系统
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1080/23288604.2022.2079448
D. Bowser, Priya Agarwal-Harding, Anna G. Sombrio, D. Shepard, Arturo Harker Roa
ABSTRACT Colombia provides a unique setting to understand the complicated interaction between health systems, health insurance, migrant populations, and COVID-19 due to its system of Universal Health Coverage and its hosting of the second-largest population of displaced persons globally, including approximately 1.8 million Venezuelan migrants. We surveyed 8,130 Venezuelan migrants and Colombian nationals across 60 municipalities using a telephone survey during the first wave of the pandemic (September through November 2020). Using self-reported enrollment in one of the several Colombian health insurance schemes, we analyzed the access to and disparities in the use of health-care services for both Colombians and Venezuelan migrants by insurance status, including access to formal health services, virtual visits, and COVID-19 testing for both groups. We found that compared with 3.6% of Colombians, 73.6% of Venezuelan telephone survey respondents remain uninsured, despite existing policies that allow legally present migrants to enroll in national health insurance schemes. Enrolling migrants in either the subsidized or contributory regime increases their access to health-care services, and equality between Colombians and Venezuelans within the same insurance schemes can be achieved for some services. Colombia’s experience integrating Venezuelan migrants into their current health system through various insurance schemes during the first wave of their COVID-19 pandemic shows that access and equality can be achieved, although there continue to be challenges.
哥伦比亚提供了一个独特的环境来理解卫生系统、医疗保险、移民人口和COVID-19之间复杂的相互作用,因为它的全民健康覆盖系统和收容了全球第二大流离失所者人口,其中包括大约180万委内瑞拉移民。在第一波疫情期间(2020年9月至11月),我们通过电话调查对60个城市的8130名委内瑞拉移民和哥伦比亚国民进行了调查。我们利用哥伦比亚几个医疗保险计划之一的自我报告登记情况,按保险状况分析了哥伦比亚和委内瑞拉移民获得医疗保健服务的机会和差异,包括两组获得正式医疗服务、虚拟就诊和COVID-19检测的机会。我们发现,与哥伦比亚的3.6%相比,73.6%的委内瑞拉电话调查受访者仍然没有保险,尽管现有政策允许合法居留的移民参加国家健康保险计划。将移徙者纳入补贴或缴费制度可以增加他们获得保健服务的机会,哥伦比亚人和委内瑞拉人在同一保险计划中可以实现某些服务的平等。哥伦比亚在2019冠状病毒病大流行第一波期间通过各种保险计划将委内瑞拉移民纳入其现有卫生系统的经验表明,尽管仍然存在挑战,但可以实现获取和平等。
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引用次数: 5
Role of User Benefit Awareness in Health Coverage Utilization among the Poor in Cambodia 用户利益意识在柬埔寨穷人利用医疗保险中的作用
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1080/23288604.2022.2058336
I. Feldhaus, Somil Nagpal, Sebastian Bauhoff
ABSTRACT The objective of this study was to understand the steps to health coverage benefit utilization in Cambodia toward improving access to health care and financial risk protection for the poor. We particularly examine the role of user awareness in the pathway to care seeking and benefit utilization with respect to the Health Equity Funds (HEF). Using 2016 survey data that were nationally representative of households with children under two years of age, we used a series of logistic regression models to evaluate associations between respondents’ awareness of benefits, public health care seeking behaviors, coverage benefit claims, and out-of-pocket expenditures. Beneficiaries were generally aware of their entitlements, although their awareness of specific benefits, such as transport reimbursement, was relatively lower. Awareness of free services at public health centers was associated with twice the odds of having ever visited a public provider for outpatient care, while awareness of free services at public hospitals was associated with higher odds of always seeking inpatient care in the public sector. Study findings point to the decision of where to seek care as the critical point in the pathway to HEF utilization. If the decision had already been made to go to a public provider, it was likely that HEF benefits were claimed. Interventions that prompt appropriate care seeking in the public sector may do the most to improve HEF utilization and subsequently improve access to care through sufficient financial risk protection.
本研究的目的是了解柬埔寨健康保险福利利用的步骤,以改善穷人获得医疗保健和财务风险保护的机会。我们特别研究了用户意识在医疗公平基金(HEF)的护理寻求和利益利用途径中的作用。利用2016年具有全国代表性的两岁以下儿童家庭的调查数据,我们使用了一系列逻辑回归模型来评估受访者对福利的认识、公共医疗保健寻求行为、保险福利索赔和自付支出之间的关联。受益人一般都知道自己应享有的权利,虽然他们对具体福利,例如运输报销的了解相对较低。认识到公共卫生中心提供免费服务的人,曾到公共医疗机构接受门诊治疗的几率增加了一倍,而认识到公立医院提供免费服务的人,总是到公共部门寻求住院治疗的几率更高。研究结果表明,在HEF利用途径中,决定在哪里就医是关键点。如果已经决定由公共供应商提供,则可能会要求HEF的福利。促使在公共部门寻求适当护理的干预措施可能最有助于提高医疗保健基金的利用,并随后通过充分的财务风险保护改善获得护理的机会。
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引用次数: 1
Amending the Law for Licensing Medical Practitioners of China in 2021: A Commentary 2021年修改《中国执业医师许可法》述评
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1080/23288604.2022.2048438
Chengxiang Tang, Jiayi Jiang, Yuanyuan Gu, Gordon Liu
ABSTRACT The Law for Licensing Medical Practitioners of the People’s Republic of China, enacted in 1999, was amended in 2021. This commentary reviews the key points of the amendment and raises doubts as to one of its points. Specifically, we argue that the minimum education level required to take the physicians’ licensing examination should be set to completion of a bachelor degree, instead of a vocational diploma or junior college graduation as in the 2021 amendment. China adopted a system of multi-tiered medical education more than 70 years ago. This policy has resulted in a threshold of entry-level medical education far below the global standards. The highly heterogeneous education background of physicians in China has led to low standards of practicing physicians, which in turn have significantly negative impacts on the health care market. We illustrate changes over time in the educational distribution and regional distribution of practicing physicians in China, and present reasons to improve entry-level educational standards, by setting the physician licensing threshold at an appropriate level. This will not only improve the overall quality of physicians but will also help address equity and efficiency issues in the health care market.
《中华人民共和国执业医师许可法》于1999年制定,并于2021年进行了修订。这篇评论回顾了修正案的要点,并对其中一点提出了质疑。具体来说,我们认为参加医师执照考试所需的最低教育水平应设定为完成学士学位,而不是像2021年修正案那样的职业文凭或大专毕业。70多年前,中国实行了多层次的医学教育制度。这一政策导致初级医学教育的门槛远远低于全球标准。中国医生教育背景的高度异质性导致执业医生的标准较低,这反过来又对医疗保健市场产生了显著的负面影响。我们阐述了中国执业医师的教育分布和地区分布随时间的变化,并提出了通过将医师执照门槛设置在适当水平来提高入门级教育标准的理由。这不仅将提高医生的整体素质,而且将有助于解决医疗保健市场的公平和效率问题。
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引用次数: 0
International Remittances and Women’s Reproductive Health Care: Evidence from Pakistan 国际汇款与妇女生殖保健:来自巴基斯坦的证据
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1080/23288604.2022.2064792
T. Mahmood, Ramesh Kumar, Asad ur Rehman, S. Pongpanich
ABSTRACT This paper determines the effect of international remittances on the healthcare utilization of childbearing mothers in Pakistan using the Pakistan Social and Living Standards Measurement (PSLM) survey, 2018–19. The study reports a significant and positive effect of international remittances on the healthcare outcomes of childbearing mothers. Importantly, the remittance-receiving households have 0.615, 0.208 and 0.306 times the odds of the non-receiving households, utilizing prenatal healthcare, postnatal healthcare, and healthcare decision making, respectively, and all of them are statistically significant. Consequently, the analysis confirms that remittance receiving-households do in fact influence and increase the likelihood of utilizing prenatal healthcare, postnatal healthcare and decisions about medical treatment for women. As regression-based estimation of remittances is prone to selection bias due to the nature of the non-experimental data set, we also used propensity score matching methods, which also confirmed a significant and positive effect of international remittances on healthcare outcomes of the childbearing mothers. Thus, financial support or social development programs by the government or non-governmental organization are pivotal in enhancing the healthcare outcomes and ultimately the living standards of childbearing mothers.
本文利用巴基斯坦社会和生活水平测量(PSLM)调查,2018-19确定了国际汇款对巴基斯坦育龄母亲医疗保健利用的影响。该研究报告称,国际汇款对生育母亲的保健结果产生了重大的积极影响。重要的是,在产前保健、产后保健和保健决策方面,收汇家庭的赔率分别是非收汇家庭的0.615倍、0.208倍和0.306倍,且均具有统计学意义。因此,分析证实,汇款接收家庭实际上确实影响和增加了妇女利用产前保健、产后保健和决定医疗的可能性。由于非实验数据集的性质,基于回归的汇款估计容易产生选择偏差,我们还使用倾向得分匹配方法,这也证实了国际汇款对生育母亲的医疗保健结果的显着和积极影响。因此,政府或非政府组织的财政支持或社会发展计划对于提高保健结果并最终提高生育母亲的生活水平至关重要。
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引用次数: 0
Decentralization Can Improve Equity, but Can It Be Sustained? 权力下放可以改善公平,但它能持续下去吗?
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2022-01-01 DOI: 10.1080/23288604.2022.2064793
T. Bossert, Rony Lenz, Ramiro Guerrero, Rene Miranda, Victoria Eugenia Soto Rojas, Norman Danilo Maldonado Vargas
Abstract A major theoretical issue about health system reform involving decentralization has been whether it promotes equity of health system funding. An article by the principal author and others in 2003 showed that, under certain conditions and policies, decentralization improved the equity of allocation of financial resources to different income levels of municipalities in Colombia and Chile. Another recurring issue has been whether reforms can be sustained over time. In a follow-up study in 2015, we found that the equity of national allocations was sustained even though the allocation rules for intergovernmental transfers and insurance funding sources had changed, as long as per capita allocation rules were retained. Nevertheless, the wealthier municipalities in Chile were able to increase their own source funding contributing to a larger gap between wealthy and poor municipalities, suggesting that in order to assure continued equity some compensation for these funds be included in intergovernmental transfer rules or that local source funding be restricted by national policy. These reforms may be more likely to be sustained if they become embedded in existing financial systems and if they receive support of status quo constituencies.
摘要卫生体制改革中涉及分权的一个重要理论问题是分权是否促进了卫生体制经费的公平性。2003年由主要作者和其他人撰写的一篇文章表明,在某些条件和政策下,权力下放改善了哥伦比亚和智利市政当局在不同收入水平上分配财政资源的公平性。另一个反复出现的问题是,改革能否长期持续下去。在2015年的后续研究中,我们发现,只要保持人均分配规则,即使政府间转移支付和保险资金来源的分配规则发生变化,国家拨款的公平性仍然保持不变。然而,智利较富裕的市政当局能够增加它们自己的来源资金,造成富裕和贫穷市政当局之间的差距更大,因此建议为了确保持续的公平,应在政府间转移规则中列入对这些资金的一些补偿,或者国家政策应限制地方来源资金。如果这些改革融入现有的金融体系,并得到维持现状的支持者的支持,它们就更有可能持续下去。
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引用次数: 1
Adam Wagstaff: Celebrating a Full and Impactful Life 亚当·瓦格斯塔夫:庆祝一个充实而有影响力的生活
IF 4.1 3区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2021-07-01 DOI: 10.1080/23288604.2021.1967258
M. Murthi, Muhammad Ali Pate
Dr. Adam Wagstaff joined the World Bank in 1999 as a Lead Economist in the Bank’s principal research department, the Development Research Group. From 2009 until his passing on May 10, 2020, he led and managed the group’s research on the economics of health, education, and social protection as Research Manager of Human Development. At the time he joined the Bank, Adam was already a preeminent scholar in health economics with groundbreaking contributions to the conceptualization and measurement of equity in health and healthcare access. However, being a highly successful academic alone was not Adam’s goal. Instead, driven by his deep, lifelong commitment to improving the lives of the poor, he was passionate about putting his and others’ research into practice. He did so in many ways, all of which have profoundly and lastingly influenced health policy worldwide. Adam was instrumental in shaping strategic policy goals both in and outside the Bank. In the early 2000s, he was deeply involved in transitioning the Bank’s mission from a focus on monetary measures of poverty to a broader agenda that emphasizes human development and other non-monetary indicators of well-being. More recently, his work on the economic dividends of a healthy population helped shape the Bank’s Human Capital Project, which centers on health and education spending as high-yield investments. Adam was also a key contributor to the development of the healthrelated Millennium Development Goals, where he successfully championed the inclusion of equity. And he was critically involved in including, operationalizing, and tracking Universal Health Coverage as a Sustainable Development Goal—a concept firmly based on his seminal work on equity in healthcare access and financial protection in health. Adam also profoundly influenced the Bank’s country operations, staunchly advocating for evidence-based decision-making and the application of economic principles as a member of the Health and Social Protection Sector Boards and as a candid peer reviewer of many project proposals. An avid mentor who was gifted with exceptional clarity as a writer and outstanding wit as a presenter, Adam maximized the impact of his work by making it accessible to both technical and non-technical audiences that spanned colleagues, government officials, academics, and students alike. Even more important to him was to empower others to conduct their own research into health equity and financial protection. To this end, he developed publicly available databases and easy-to-operate software tools, taught their application across the globe, and initiated many scientific collaborations between researchers in lowand middleand high-income countries. Despite this strong commitment to practice, Adam remained a prolific writer of scientific papers, books, reports, and blogs throughout his career at the Bank, putting him among the top 20 most cited health economists in the world. Adam epitomized intellectual curiosity, rigor a
亚当·瓦格斯塔夫博士于1999年加入世界银行,担任世行主要研究部门——发展研究局的首席经济学家。从2009年到他于2020年5月10日去世,他作为人类发展研究经理领导和管理该集团关于健康、教育和社会保护经济学的研究。在加入世行时,亚当已经是卫生经济学领域的杰出学者,在卫生和医疗保健公平性的概念化和衡量方面做出了开创性贡献。然而,仅仅成为一个非常成功的学者并不是亚当的目标。相反,在他毕生致力于改善穷人生活的深深驱使下,他热衷于将自己和他人的研究付诸实践。他在许多方面做到了这一点,所有这些都深刻而持久地影响了世界各地的卫生政策。亚当在制定世行内外的战略政策目标方面发挥了重要作用。21世纪初,他深入参与了世行使命的转型工作,从侧重于货币衡量贫困转向更广泛的议程,强调人类发展和其他非货币的福祉指标。最近,他关于健康人口的经济红利的研究帮助塑造了世行的人力资本项目,该项目以卫生和教育支出为中心,将其作为高收益投资。亚当也是制定与卫生有关的千年发展目标的关键贡献者,他成功地倡导将公平纳入其中。他还积极参与了将全民健康覆盖纳入、实施和跟踪作为一项可持续发展目标的工作,这一概念牢固地建立在他关于卫生保健公平获取和卫生财务保护的开创性工作的基础上。亚当还对世行的国别业务产生了深远影响,他作为卫生和社会保护部门委员会成员和许多项目提案的坦率同行评议人,坚定倡导循证决策和经济原则的应用。作为一个热心的导师,作为一个作家,亚当有着非凡的清晰的写作天赋,作为一个演讲者,他的作品对同事、政府官员、学者和学生等技术和非技术观众都有很大的影响。对他来说,更重要的是授权他人进行自己的健康公平和财务保护研究。为此,他开发了公开可用的数据库和易于操作的软件工具,在全球范围内教授它们的应用,并在低收入、中等收入和高收入国家的研究人员之间发起了许多科学合作。尽管对实践有着坚定的承诺,亚当在世行的整个职业生涯中仍然是一名多产的科学论文、书籍、报告和博客作者,使他成为世界上被引用最多的20名卫生经济学家之一。亚当体现了求知欲,严谨和卓越,对数据和基于证据的决策的坚定承诺,对有效沟通和知识共享的热情,以及对改善最需要帮助的人的生活这一目标的不耐烦。COVID-19大流行对卫生系统和经济造成的严重破坏,对再次崛起的贫困阶层构成了特别威胁,使这些品质和卫生公平和财务保护的目标成为现实
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Health Systems & Reform
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