overview of phr plus activities in jordan n.
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Overview of PHR plus Activities In Jordan. Dr. Salwa Bitar. Summary of Activities. Health Insurance Reform National Health Accounts (NHA) Hospital Decentralization. Need for NHA. Systematic analysis of total health care spending (public and private) not available

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summary of activities
Summary of Activities
  • Health Insurance Reform
  • National Health Accounts (NHA)
  • Hospital Decentralization
need for nha
Need for NHA
  • Systematic analysis of total health care spending (public and private) not available
  • Limited data on household use and spending on health care services
  • Need for comprehensive data for policy analysis and decisions
  • NHA - an integrated way of keeping track of resource flows in a health care system
nha results in brief
NHA Results(In Brief)
  • Total expenditures on health care: JD 454 million
  • Per capita expenditures on health care: JD 94
  • Health care expenditures as a percent of GDP: 9.1%
  • Pharmaceuticals: JD158 (35% of total)
  • 61 percent of expenditures for curative treatment, and 25% for primary care services
additional outcomes of nha
Additional Outcomesof NHA
  • Established team of NHA experts (RMS, MOH, JUH), that are committed to the institutionalization of their efforts
  • Realization of the need to develop a public sector/private sector partnership, in future NHA activities
  • Established strong support for the need to institutionalize NHA
health insurance reform background
Health Insurance ReformBackground
  • Round table discussion to consider the issues (April 98)
  • Assessment of Third Party Payers, such as private insurance companies and their role in the health economy (June 98)
  • Survey of Shareholding Companies, these are companies that are listed on the Jordanian stock exchange (Aug 98)
  • Workshop on Insuring the Uninsured (Nov 98)
  • Focus Groups on health care needs of population (June 99)
  • Profile of the Uninsured in Jordan (July 99)
  • Survey of 500 private companies in Jordan (Sep 99)
  • Jordan Health Care Utilization and Expenditure Survey (Dec 2000)
phr plus insurance reform
PHRplus Insurance Reform
  • Take a more systematic, gradual approach to reform
  • Focus on private sector contracting for hospital based services (system needs to be improved)
  • Improve the contracting abilities of the Health Insurance Directorate (managerially and technically)
  • Establish functioning Implementation Unit, and Advisory Board that will lead to subsequent National Health Insurance Board
  • Distribute “cost-savings” such that services are expanded to uninsured Jordanians
advantages of reform efforts
Advantages of Reform Efforts
  • The MOH has identified the need to establish improved regulations concerning the distribution and consumption of pharmaceuticals (35% of health expenditures)
  • The MOH is now realizes the need to redistribute funding from curative care to primary health care services (61% vs versus 25%)
  • The MOH can now accurately estimate the cost of producing hospital services (cost studies)
advantages of reform efforts continued
Advantages of Reform Efforts(continued)
  • The MOH now realizes the need to include evidence based research into its policy design
  • The MOH has gained an appreciation of the need to have personnel that are specialized and assigned to stable job assignments (e.g., the MOH PHRplus counterparts have been assigned to the project since 1998)
  • The realization that effective and efficient reform requires the participation of all health care sectors, as well as coordination among donor organizations
challenges to reform
Challenges to Reform
  • High turnover of senior level executives within the MOH (7 Ministers of Health since 1998)
  • Lack of coordination and dialogue across government agencies and ministries
  • Lack of private sector participation in reform efforts