How primary health care can make universal health coverage a reality, ensure healthy lives, and promote wellbeing for all

Kluge, Hans; Kelley, Ed; Barkley, Shannon; Theodorakis, Pavlos N; Yamamoto, Nobuto; Tsoy, Alexey; Aiypkhanova, Ainur; Ganesh, V Pusapati; Hipgrave, David; Peterson, Stefan; Valderas, José M; Mossialos, Elías

doi:10.1016/s0140-6736(18)32482-6

Cited by 34 publications

(21 citation statements)

References 1 publication

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“…A strong PC system can facilitate for instance a comprehensive care coordination [129,130], and this context influences the adoption of eHealth applications. Moreover, in order to support PC, available and accessible health technologies thus "offers an opportunity that cannot be missed" ( [131], p. 1373), by expanding the range of addressed health conditions and available related treatments [91]. eHealth shows thus a general good potential, and in this regard, decentralized countries with NHS and strong/medium PC seem to represent the more adequate contexts.…”

Section: Discussionmentioning

confidence: 99%

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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Introduction. eHealth applications have the potential to provide new integrated care services to patients with multimorbidity (MM), also supporting multidisciplinary care. The aim of this paper is to explore how widely eHealth tools have been currently adopted in integrated care programs for (older) people with MM in European countries, including benefits and barriers concerning their adoption, according to some basic health system characteristics. Materials and Methods. In 2014, in the framework of the ICARE4EU project, expert organizations in 24 European countries identified 101 integrated care programs. Managers of the selected programs completed an online questionnaire on several dimensions, including the use of eHealth. We analyzed data from this questionnaire, in addition to qualitative information from six innovative programs which were studied in depth through case study methodology, according to characteristics of national health systems: a national health model (financing system), overall strength of primary care (PC) (structure/service delivery process), and level of (de)centralization of health system (executive powers in a country). Results. 85 programs (out of 101) adopted at least one eHealth tool, and 42 of these targeted explicitly older people. In most cases, Electronic Health Records (EHRs) were used and some benefits emerged like improved care management and integration, although inadequate funding mechanisms represented a major barrier. The analysis by health system characteristics showed a greater adoption of eHealth applications in decentralized countries, in countries with a National Health Service (NHS) model, and in countries with a strong/medium level of PC development. Conclusions. Although in the light of some limitations, findings indicate a relation between implementation of care programs using eHealth tools and basic characteristics of health systems, with decentralization of a health system, NHS model, and strong/medium PC having a key role. However adaptations of European health systems seem necessary, in order to provide a more innovative and integrated care.

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Section: Discussionmentioning

confidence: 99%

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Melchiorre

Papa

Quattrini

et al. 2020

BioMed Research International

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“…Third, a strong PHC system should be regarded as a core component in realising UHC. Along with the new Declaration of Astana, PHC for health as a global priority is the pathway to reach the SDGs and UHC 68. In the early days, some experience in PHC in China demonstrated that ‘health for all’ is a practical possibility, for example, the ‘Patriotic Health Campaign’ and ‘Barefoot Doctors’ 69.…”

Section: Lessons From China’s Experiencementioning

confidence: 99%

Towards universal health coverage: lessons from 10 years of healthcare reform in China

et al. 2020

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Universal health coverage (UHC) is driving the global health agenda. Many countries have embarked on national policy reforms towards this goal, including China. In 2009, the Chinese government launched a new round of healthcare reform towards UHC, aiming to provide universal coverage of basic healthcare by the end of 2020. The year of 2019 marks the 10th anniversary of China’s most recent healthcare reform. Sharing China’s experience is especially timely for other countries pursuing reforms to achieve UHC. This study describes the social, economic and health context in China, and then reviews the overall progress of healthcare reform (1949 to present), with a focus on the most recent (2009) round of healthcare reform. The study comprehensively analyses key reform initiatives and major achievements according to four aspects: health insurance system, drug supply and security system, medical service system and public health service system. Lessons learnt from China may have important implications for other nations, including continued political support, increased health financing and a strong primary healthcare system as basis.

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“…[3] As stated in the Sustainable Development Goals (SDG) 3.8, [3] the WHO seeks to expand UHC to one billion additional people by 2030. [4][5][6] To meet this goal, governments must commit to increasing public healthcare nancing, while progressively increase access to essential medicines. Also, they must guarantee coverage to vulnerable groups, especially women and girls from the poorest wealth quintile.…”

Section: Introductionmentioning

confidence: 99%

Strengthening health systems to achieve Universal Health Coverage: Lessons from four Latin American countries.

Gilardino¹,

B²,

Valanzasca³

2020

Preprint

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Background: During the 1990s, health systems within several Latin American countries changed to expand service coverage and reach more people. These changes are considered the antecedent of the Universal Health Coverage (UHC). Seven years after the United Nations’ call for UHC, healthcare services in Argentina, Brazil, Colombia, Mexico are generally accessible and affordable. However, these countries increasingly struggle to meet their populations’ growing health needs while also addressing rising health care costs. This research aims to describe measures taken by these four countries to commit by UHC, addressing their barriers and challenges. Methods: This study examined literature review data, supplemented with survey data collected from regional stakeholders. Data were analyzed within an ad-hoc matrix.Results: These four countries increased healthcare services coverage by strengthening their primary healthcare systems. They also expanded coverage for non-communicable diseases, provided community outreach, and increased the number of skilled healthcare workers. New pharmaceutical support programs provided access to treatments for chronic conditions at zero cost, while high-costs drugs and cancer treatments were partially guaranteed. However, these measures did not achieve full financial protection to all, leaving citizens exposed to possible catastrophic expenditures, despite increased service coverage. UHC is funded primarily through taxes and polling resources, and these four countries still struggle to find mechanisms that could increase pooling mechanisms capable of increasing service coverage, while reducing financial inequities among people. Conclusions: Argentina, Brazil, Colombia, and Mexico have made progress towards UHC. Nevertheless, additional mechanisms to sustain financial protection are urgently required. The decentralization of the primary healthcare system, the development of public-private partnerships, and the implementation of progressive financing mechanisms like conditional cash transfers are potential manners to improve service delivery and financial protection contributing to effective UHC.

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How primary health care can make universal health coverage a reality, ensure healthy lives, and promote wellbeing for all

Cited by 34 publications

References 1 publication

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems

Towards universal health coverage: lessons from 10 years of healthcare reform in China

Strengthening health systems to achieve Universal Health Coverage: Lessons from four Latin American countries.

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