Table 3 Implemented interventions in developed and developing countries
From: Strategies for reducing out of pocket payments in the health system: a scoping review
| Interventions in developed countries | Asia |
-Medical subsidy for children -Universal health coverage; this is achieved through public health insurance |
| America |
-Prescription content and Choosing right pharmacy -Writing 90-day prescriptions and choosing the lowest-cost generic drugs by Prescribers -Requesting inexpensive generic drugs by patients -Control strategies drug price -Employ centralized price and comparative and cost-effectiveness research for determining price ceilings -Universal health coverage -Strategies Involving Care-Plan Changes: Changing to lower-cost alternative intervention, Switching to generic form of intervention, changing dosage/frequency of intervention -Strategies not involving care-plan changes: Changing logistics of care, ––Facilitating co-pay assistance or coupons, Providing free samples, changing or adding insurance plans -Innovation in drug pricing to include value, the introduction of performance-based payment -Removal of consumer cost-sharing for contraceptives -Federal coverage in eliminating OOP costs among privately insured women for at least some methods of contraception -Improve private health plans -Choose a brand-name drug with a generic equivalent -Free breast cancer screening -Drug coupons for multiple sclerosis -Adults individual insurance -The Medicare insurance -Prioritize public financing of services for the poor -Promoting the quality of primary care services; -Mobilizing OOP payments on a pre-paid basis through formal or community-based risk-pooling schemes -Using brief just-in-time interventions at the point of prescription ordering by physicians -Discontinuing nonessential medicines -Use of an over-the-counter medicine as a substitute -Refer the patient to a public aid agency or social worker | |
| Oceania | -Telehealth (on-line video consultation) | |
| Europe |
-Inclusion of dental care coverage in health insurance packages -Integrating the prevention and control of oral diseases into universal health insurance coverage programs | |
| Interventions in developing countries | Asia |
-Government support of public health insurance program -Subsidy program for diseases with a high economic burden -Prevent and control chronic diseases -Training the physicians -Developing clinical guidelines -Universal health coverage -Diagnosis-related group (DRG)–based payment system -Expanding the dental health reform -Providing care closer to home -Improve the effectiveness of services -Regularly updating the essential list of drugs according to need of patients -Mandatory social insurance program for urban employees -Insurance for children, students, the elderly, the disabled, and other unemployed populations in urban regions groups not covered by basic health insurance -Catastrophic Disease Insurance -Increase the efficiency and quality of care -National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Disease, and Stroke -Free treatment to the vulnerable segment of the population for the treatment of cancer and heart diseases -Create patient transport system in remote locations -Fees exemption for the poor, disabled, and disadvantaged -Public and private insurance -More investment for health from social health insurance and tax-based government funding -Inclusion of private providers in the system -Decrease and even eliminate the copayments for those at low-income levels -Clear the system from informal payments -Innovative financing mechanisms on the collection, pooling, and purchasing side |
| Africa |
-Free maternal health care policy -Screening and in situ treatment of precancerous cervical lesions for women between 25 and 55 years old and clinical screening for breast cancer at age 15 -Limiting prescription of brand-name drugs, x-ray and ultrasound orders, screening tests, advanced lab tests, ward/ICU admission, surgery -Discharging patients earlier -Refuse expensive drug requested by patients or families -Reducing informal fees |