Table 2 Component affecting on out of pocket reducing
From: Strategies for reducing out of pocket payments in the health system: a scoping review
Main components | Subcomponents | References | Reference evidence |
|---|---|---|---|
Stewardship | Regulatory | -Developing clinical guidelines [17] -Pro-poor health financing policy focusing on financial protection not only for those close to the poverty line, but also those who are already below it in both rural and urban areas [5] -Inclusion of private providers in the system [29] | |
Implement regulations | [15, 16, 18,19,20, 22, 23, 30,31,32,33,34,35,36,37,38,39,40,41,42] | -Broadly implement DRGs and refine payment systems [33] -Universal health insurance coverage programs [28] -Create patient transport system in remote locations [38] | |
Regulatory monitoring | -A need for federal and state policymakers to reexamine how state agencies are applying the cost-sharing protections for contraception under Medicaid and Medicaid managed care plans [27] -Ensuring more investment for health from social health insurance and/or tax-based government funding [36] | ||
Creating resources | Facilities | -The need for availability of drugs and medical supplies at the public facility [15] -Improving access to healthcare facilities like diagnostic test [32] -Telehealth (on-line video consultation) [44] | |
Personnel | -Training the physicians [17] -Physicians should develop the habit of using brief just-in-time interventions at the point of prescription ordering [45] | ||
Financing | Revenue collection | -Innovative financing mechanisms on the collection side to reduce the intensity of poverty [5] -Exemption process of fees for the poor, disabled, and disadvantaged [19] | |
Pooling | -Mobilizing OOP payments on a pre-paid basis through formal or community-based risk-pooling schemes [24] -Enrolment into health insurance [37] -Basic Insurance Scheme (BIS) (Retired workers are exempt from premium contributions, and the cost of their contributions is to be borne by their former employers) [48] | ||
Purchasing | -Diagnosis-related group (DRG)–based payment system [49] -Performance-based payment [14] | ||
Delivering services | Prevention | -Screening and in situ treatment of precancerous cervical lesions for women between 25 and 55Â years old [16] -The National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease and Stroke [31] -Breast cancer screening [51] -Integrating the prevention and control of oral diseases into universal health insurance coverage programs [28] | |
Treatment | -The improved effectiveness of services [15] -Limiting X-ray and ultrasound orders [50] -Switching to a generic form of intervention [6] |