Transcript Overview of PHRplus Activities in Jordan

Overview of PHRplus Activities
In Jordan
Dr. Salwa Bitar
Partnerships
for Health
Reform
Summary of Activities
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Health Insurance Reform
National Health Accounts (NHA)
Hospital Decentralization
Need for NHA
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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)
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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
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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
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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)
PHRplus Insurance Reform
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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
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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
Advantages of Reform Efforts
(continued)
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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
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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