شناسايي چگونگي روشهاي تامين منابع مالي نظام سالمت كشورهاي منتخب در فاصله سالهاي 2004-1998 و ارايه ساز و كارهاي توليد منابع مالي جديد در نظام سالمت ايران‌

Survey of Different Approaches to Health System Financing in the Selected Countries during the Period 1998-2004 and Introducing New Financing Mechanisms for Iran

Health Systems aim to improve health by delivering health care services. But sometimes in low-income countries, people become poor when they use these services. So, it is required to analyze the experience of health system financing in the selected countries and develop strategies to improve the efficiency of health system financing. The objective of the paper is to identify the main determinants of health care expenditures in 10 DEeD countries over the period 1998-2004. The major determinants of health care expenditures which are theoretically identified comprise the total government revenue earned from health care system, social security expenditures on health, Out-of-pocket expenses on health, and the ratio of ex ante payments of private sector on health over the total health expenditures. The stylized facts of the study shows the principles of equity-base health policy planning are notification of financing mechanisms in health sector, identity of financing model according to the county socioeconomic conditions, financial capacity, infrastructure, capability of implementing selected policies, political responsibility and accountability for these policies. The findings of estimates confirm that family health care expenditures are affected by total Government expenditures on health, Social security expenditures on health, Out-of-pocket expenditures on health, and the ratio of ex ante payments of private sector on health over the total health care expenditures. These results are used to propose some new financing mechanisms to fmance health expenditures in Iran. The evidence shows that the following approaches will generate new financial resources and increase the effectiveness of the health policy, and improve justice in the Iranʹs health system: • Financing health care expenditures through taxation and more specifically imposing progressive tax rates • Designing and implementing of comprehensive information system • Determining health service prices based on actual costs • Designing and implementing effective strategies to target the health care subsidyʹs system to the poor and vulnerable populations • Improving the private and public sectorsʹ cooperations in delivering the health care services • Increasing transparency of the private and public financial contribution in the health care system • Organizing the charity activities in health sector and monitoring their resources and expenditures