SAHR 2007 - Health Systems Trust

More documents

Recommendations

Info

Health and Related Indicators 15 District health financing indicators This year the district level estimates of expenditure per capita on non-hospital PHC have been updated. This is a key input indicator of equity, and analysis of the trends between 2001/02, 2005/06 and 2006/07 indicate that in general equity between districts is improving, with the ratio between the highest and lowest expenditure reducing from 9.3 in 2001/02 to 3.5 in 2005/06 and 3.3 in 2006/07. Methodology Data from the Basic Accounting System (BAS) financial database for all provinces except North West were obtained in June 2007 from Vulindlela for the 2005/06 and 2006/07 financial years. Data from North West were obtained from the chief financial officer of the province. Additional data sources included: ➤ Data on local government expenditure on primary health care from National Treasury. Net expenditure was used, i.e. expenditure less income (which includes transfers from provinces to LG). ➤ Factors for inflation adjustments based on CPIX were obtained from National Treasury to convert all values to real 2006/07 prices. ➤ Population data from the DHIS, based on extension of StatsSA figures to sub-district level. ➤ Medical scheme coverage from StatsSA General Household Survey 2005 and 2006 to calculate the uninsured population. It is noted that the GHS and other sources indicate that there is significant use of the private sector by the uninsured population and also some use of the public sector by the insured population, however for the purposes of these calculations we have divided public sector expenditure by the uninsured population in order to estimate per capita expenditure. Health Financing – Public sector Expenditure from sub-programmes 2.1-2.5 (District management, Community health clinics, Community health centres, Community-based services and Other community services) constitute the non-hospital PHC expenditure under District Health Services. All expenditure was then allocated to districts using primarily information in the ‘Responsibility_lowest_level’ and other ‘Responsibility’ fields. The DHIS facilities file was used to code all entries linked to individual health facilities. Expenditure which could not be allocated to a specific district was subsequently allocated to all of the districts within the relevant province in proportion to the total population share of each district. Expenditure that was allocated to a region including 2 districts was similarly allocated to each district within that region according to population share. Finally, expenditure for cross-boundary districts was combined and included as one item in the province that the district is located in according to the new demarcation boundaries. This means that for the purposes of analysis of per capita expenditure at district level, some expenditure which is originally recorded in one province may be shown under a different province. Net local government expenditure on health services was added to provincial expenditure on non-hospital PHC, and this total was divided by the uninsured population to obtain expenditure on non-hospital PHC per capita. The figures have all been adjusted to take the effect of inflation into account and are presented in real 2006/07 prices. A matter of concern is that for some provinces, expenditure is still not clearly allocated to districts. This suggests that financial management of health is still not taking place with a focus at district level, and it is suggested that district coding become a part of the required coding of financial information. Another area that is difficult to separate clearly and verify is that of transfers to local government. ➤ ➤ Geographic information from the Municipal Demarcation Board. Data on health facilities from the DHIS. Provincial expenditure is coded according to the programmes and sub-programmes published by National Treasury (see Table 55). This coding was cleaned and made consistent across the provinces. For MP, information from the field ‘Objective_lowest_level’ was used to distinguish sub-programmes under PR2: District Health Services. 321
Table 55: Budget programme structure for provincial health expenditure Programmes PR1 Administration PR2 District Health Services Sub-programmes Non-hospital PHC District management Community health clinic services Community health centres Community-based services Other community services HIV/AIDS Nutrition District Hospitals Coroner Services Others PR3 PR4 PR5 PR6 PR7 PR8 Emergency Medical Service Provincial Hospital Services Central Hospital Services Health Sciences and Training Health Care Support Services Health Facilities Management Other 322
Page 2 and 3:
South African Health Review 2007 LI
Page 4:
Foreword The 12th edition of South
Page 7 and 8:
12 Traditional and Complementary Me
Page 9 and 10:
Other Funders for the Health System
Page 11 and 12:
This response raises a number of qu
Page 13 and 14:
ucts are currently sold without reg
Page 15 and 16:
The authors conclude that mandatory
Page 17 and 18:
servicing and inappropriate hospita
Page 19 and 20:
systems is also critical; worrying
Page 22 and 23:
Authors: Laetitia Rispel i Geoffrey
Page 24 and 25:
Stewardship: Protecting the Public
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
Page 34 and 35:
Page 36:
Page 39 and 40:
Introduction The importance of the
Page 41 and 42:
diseases such as tuberculosis and t
Page 43 and 44:
17 of 2002). This Act entirely repl
Page 45 and 46:
(d) and any other matter relating t
Page 47 and 48:
Year Act No. Title Objects 1997 90
Page 49 and 50:
References 1 Department of Health.
Page 52:
Purchasing of Health Care 33Pooling
Page 55 and 56:
Introduction This chapter presents
Page 57 and 58:
Medical schemes are the largest fin
Page 59 and 60:
per person dependent on the public
Page 61 and 62:
An increase in hospital expenditure
Page 63 and 64:
private pharmacy do so for self-tre
Page 65 and 66:
References 1 McIntyre D, Thiede M,
Page 67 and 68:
Policy and legislative framework In
Page 69 and 70:
Medical schemes and revenue collect
Page 71 and 72:
There is evidence that when faced w
Page 73 and 74:
are thus contributing factors to th
Page 75 and 76:
Figure 2: Historic membership of me
Page 77 and 78:
Solvency of the risk pools has beco
Page 79 and 80:
Figure 4: 100 Proportion of risk be
Page 81 and 82:
will retain that benefit for their
Page 83 and 84:
There is a general sense (but often
Page 85 and 86:
From a benefit design perspective t
Page 87 and 88:
and towards competition based on ef
Page 89 and 90:
37 Du Preez L. Registrar wants cura
Page 91 and 92:
Introduction There has long been co
Page 93 and 94:
an element of cream-skimming which
Page 95 and 96:
Table 1: Distribution of health car
Page 97 and 98:
isk equalisation mechanism were imp
Page 99 and 100:
once the cost spiral in medical sch
Page 101 and 102:
Revenue collection: Collecting orga
Page 103 and 104:
Current debates A key area of ongoi
Page 105 and 106:
References 1 Gluckman H. The Provis
Page 108 and 109:
Authors: Patrick Matshidze i Lyn Ha
Page 110 and 111:
Health Information Systems in the P
Page 112 and 113:
Page 114 and 115:
Page 116 and 117:
Page 118 and 119:
Page 120 and 121:
Page 122 and 123:
Authors: Shahieda Adams i Reno Mora
Page 124 and 125:
Health and Health Care in the Workp
Page 126 and 127:
Page 128 and 129:
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
Author: Bettina Taylor i 8 Rationin
Page 144 and 145:
Rationing of Medicines and Health C
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Health Care Delivery 139
Page 160 and 161:
Authors: Haroon Wadee i Farzana Kha
Page 162 and 163:
Human Resources for Health 9 Table
Page 164 and 165:
Human Resources for Health 9 Table
Page 166 and 167:
Human Resources for Health 9 source
Page 168 and 169:
Human Resources for Health 9 Refere
Page 170 and 171:
Authors: Shadrack Shuping i Sipho K
Page 172 and 173:
Public-Private Partnerships 10 Alth
Page 174 and 175:
Public-Private Partnerships 10 Tabl
Page 176 and 177:
Public-Private Partnerships 10 Conc
Page 178 and 179:
Authors: Thulani Matsebula i Michae
Page 180 and 181:
Private Hospitals 11 Table 1: Priva
Page 182 and 183:
Private Hospitals 11 Table 3: Distr
Page 184 and 185:
Private Hospitals 11 Human resource
Page 186 and 187:
Private Hospitals 11 Figure 3: 16 T
Page 188 and 189:
Private Hospitals 11 Figure 4: 2 50
Page 190 and 191:
Private Hospitals 11 Monitoring qua
Page 192 and 193:
Private Hospitals 11 Recommendation
Page 194 and 195:
Authors: Nceba Gqaleni i Indres Moo
Page 196 and 197:
Traditional and Complementary Medic
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Page 208 and 209:
Authors: Myles Mander i Lungile Ntu
Page 210 and 211:
Economics of the Traditional Medici
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Authors: Marion Stevens i Edina Sin
Page 222 and 223:
HIV and AIDS, STI and TB in the Pri
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
Indicators 213
Page 234 and 235:
Authors: Candy Day i Andy Gray ii 1
Page 236 and 237:
Health and Related Indicators 15
Page 238 and 239:
Health and Related Indicators 15
Page 240 and 241:
Health and Related Indicators 15 Ta
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Page 248 and 249:
Health and Related Indicators 15 Th
Page 250 and 251:
Page 252 and 253:
Page 254 and 255:
Health and Related Indicators 15 Tu
Page 256 and 257:
Health and Related Indicators 15 Fi
Page 258 and 259:
Health and Related Indicators 15 He
Page 260 and 261:
Page 262 and 263:
Health and Related Indicators 15 tr
Page 264 and 265:
Page 266 and 267:
Page 268 and 269:
Page 270 and 271:
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
Page 278 and 279:
Page 280 and 281:
Health and Related Indicators 15 Nu
Page 282 and 283:
Page 284 and 285:
Health and Related Indicators 15 19
Page 286 and 287:
Page 288 and 289:
Page 290 and 291: Health and Related Indicators 15 No
Page 292 and 293: Health and Related Indicators 15 Ta
Page 294 and 295: Health and Related Indicators 15 Be
Page 296 and 297: Health and Related Indicators 15 He
Page 298 and 299: Health and Related Indicators 15 Fi
Page 302 and 303: Health and Related Indicators 15 De
Page 304 and 305: Health and Related Indicators 15 Ma
Page 306 and 307: Health and Related Indicators 15 Ea
Page 308 and 309: Health and Related Indicators 15 Fr
Page 310 and 311: Health and Related Indicators 15 Ga
Page 312 and 313: Health and Related Indicators 15 Kw
Page 316 and 317: Health and Related Indicators 15 Li
Page 318 and 319: Health and Related Indicators 15 Mp
Page 324 and 325: Health and Related Indicators 15 We
Page 326 and 327: Health and Related Indicators 15
Page 336 and 337: Health and Related Indicators 15 Pu
Page 346 and 347: Health and Related Indicators 15 In
Page 350 and 351: Health and Related Indicators 15 In
Page 352 and 353: Health and Related Indicators 15 Ty
Page 358 and 359: Health and Related Indicators 15 Ch
Page 360 and 361: Health and Related Indicators 15 MD
Page 362 and 363: Health and Related Indicators 15 St
Page 364 and 365: Glossary AFA AIDS ALP AMA ANC ART A
Page 366 and 367: Glossary KZN LFS LIMS LP LPP MAR MC
Page 368 and 369: Glossary SAPC SARS SASIM SASSA SEP
Page 370 and 371: Index A Acts (Legislation and Bills
Page 372 and 373: Index N and O National Health Refer
show all

SAHR 2007 - Health Systems Trust

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?