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[黎巴嫩的卫生筹资。一、医疗服务的组织、覆盖体系及公共卫生部的贡献]

[Health financing in Lebanon. I. Organization of health care services, coverage system and contribution of the Ministry of Public Health].

作者信息

Ammar W, Awar M

机构信息

Ministère de la Santé, Rue du Musée, Beyrouth, Liban.

出版信息

J Med Liban. 1998 May-Jun;46(3):149-55.

Abstract

This paper intends to analyze the health care system in Lebanon from the organizational and financial points of view. It allows for an understanding of the health services' market by tackling it from different angles: supply versus demand, private versus public sectors, curative versus preventive services, hospital versus ambulatory care. This study necessitated a review of all previous surveys made in this field, during the after-war period. It also needed the daily collection and follow-up of pertinent data with all private and public agencies and concerned ministries, over a one-year period. In addition, a critical analysis has been made to the survey Conditions de vie des ménages, en 1997, that was carried out by the Central Administration of Statistics, that came to complete the missing data concerning household expenditures on insurance and health services. Especially that this survey covered the same period (1997), subject of this study. The paper reveals that, although the private sector is the main provider of both hospital and ambulatory care, private hospitals are flourishing on public money, whereas outpatients care is mainly financed by the households. Evidence shows that the Lebanese health care system succeeded in resolving the problem of accessibility to primary, secondary and tertiary health care, responding thus to the value of equity. But, at the price of an ever escalating cost, threatening the sustainability of the system. This is what is attained in this paper, as it shows clearly that expenditures on health have reached an alarming level of the GDP share. Our purpose being providing solid arguments in favor of reforming the health system.

摘要

本文旨在从组织和财务角度分析黎巴嫩的医疗保健系统。通过从不同角度探讨医疗服务市场,即供给与需求、私营部门与公共部门、治疗性服务与预防性服务、医院护理与门诊护理,从而增进对该市场的理解。本研究需要回顾战后时期该领域此前进行的所有调查。此外,还需要在一年时间内每日收集并跟踪与所有私营和公共机构及相关部委有关的相关数据。此外,对中央统计局于1997年开展的“家庭生活状况”调查进行了批判性分析,该调查补充了有关家庭保险和医疗服务支出的缺失数据。特别是因为这项调查涵盖了本研究的同一时期(1997年)。本文揭示,尽管私营部门是医院护理和门诊护理的主要提供者,但私立医院靠公共资金蓬勃发展,而门诊护理主要由家庭提供资金。有证据表明,黎巴嫩医疗保健系统成功解决了获得初级、二级和三级医疗保健的问题,从而体现了公平价值。但代价是成本不断攀升,威胁到该系统的可持续性。本文就是这样得出的结论,因为它清楚地表明,卫生支出占国内生产总值的比例已达到令人担忧的水平。我们的目的是为改革卫生系统提供有力论据。

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