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Article
Author(s)
Gustave Karara1, 2, Frank Verbeke1, 2 and Marc Nyssen1, 2
Full-Text PDF XML 1497 Views
DOI:10.17265/2328-7136/2017.05.001
Affiliation(s)
1. Department of Public Health, Biostatistics and Medical Informatics, Vrije Universiteit Brussel, Brussels 1080, Belgium
2. Regional e-Health Center of Excellence, School of Public Health, University of Rwanda, Kigali-City, Kicukiro, Rwanda
ABSTRACT
UHC (Universal Health
Coverage) is at the center of the Sustainable Development Agenda. In this study,
the authors made an evaluation of the indicators allowing quantification of the
impact of health coverage schemes on patients, applied in 4 sub-Saharan Africa countries:
Rwanda, Burundi, the DRC (Democratic
Republic of Congo) and
Mali. After an analysis of potential health coverage indicators,
the most relevant ones were calculated on the basis of patient administrative and
health insurance data, collected via OpenClinic GA, an HIMS (health information management system) used in 8 sub-Saharan hospitals during the period
2010-2016. The
results show that the PHSC (patient health services coverage) rate is highest (81.5%-92.7%)
in the 2 hospitals of Rwanda and in 2 hospitals of Burundi (37.7%-77.7%). The PHSP
(patient health service payment) rate as the proportion of costs paid by the patient
versus total health service costs is below the 25% threshold recommended by WHO
only for the 2 hospitals in Rwanda. The POOP (patient out-of-pocket) payment is below the threshold of 180USD per patient
per year for all hospitals. The HIEXs (health insurance expenditures) are funded by the university private
insurance (86% of expenses covered) in 2 university teaching hospitals in DRC, by
CBHI (community based health insurance) (69%) in 2 hospitals in Rwanda, by the free care
policy (77%) in 2 hospitals in Burundi and by the SHI (social
health insurance) (100%) in the 2 hospitals in Mali. PHSC in the 8 reference hospitals reflects the national
trend towards UHC in each country. With
this study, we demonstrate the possibility to assess the degree of UHC in developing
countries, by a methodology based on indicators calculated via information extraction from routine data in electronic health
records.
KEYWORDS
UHC, health insurance schemes, patient health coverage indicators, sub-Saharan reference hospitals.
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