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The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam

The Lancet Commission on Diagnostics highlighted a huge gap in access to diagnostic testing even for basic tests, particularly at the primary care level, and emphasised the need for countries to include diagnostics as part of their universal health coverage benefits packages. Despite the poor state...

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Autores principales: Bigio, Jacob, Hannay, Emma, Pai, Madhukar, Alisjahbana, Bachti, Das, Rishav, Huynh, Huy Ba, Khan, Uzma, Mortera, Lalaine, Nguyen, Thu Anh, Safdar, Muhammad Aamir, Shrestha, Suvesh, Venkat Raman, A, Verma, Sharat Chandra, Yellappa, Vijayashree, Srivastava, Divya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364157/
https://www.ncbi.nlm.nih.gov/pubmed/37479500
http://dx.doi.org/10.1136/bmjgh-2023-012512
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author Bigio, Jacob
Hannay, Emma
Pai, Madhukar
Alisjahbana, Bachti
Das, Rishav
Huynh, Huy Ba
Khan, Uzma
Mortera, Lalaine
Nguyen, Thu Anh
Safdar, Muhammad Aamir
Shrestha, Suvesh
Venkat Raman, A
Verma, Sharat Chandra
Yellappa, Vijayashree
Srivastava, Divya
author_facet Bigio, Jacob
Hannay, Emma
Pai, Madhukar
Alisjahbana, Bachti
Das, Rishav
Huynh, Huy Ba
Khan, Uzma
Mortera, Lalaine
Nguyen, Thu Anh
Safdar, Muhammad Aamir
Shrestha, Suvesh
Venkat Raman, A
Verma, Sharat Chandra
Yellappa, Vijayashree
Srivastava, Divya
author_sort Bigio, Jacob
collection PubMed
description The Lancet Commission on Diagnostics highlighted a huge gap in access to diagnostic testing even for basic tests, particularly at the primary care level, and emphasised the need for countries to include diagnostics as part of their universal health coverage benefits packages. Despite the poor state of diagnostic-related services in low-income and middle-income countries (LMICs), little is known about the extent to which diagnostics are included in the health benefit packages. We conducted an analysis of seven Asian LMICs—Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, Viet Nam—to understand this issue. We conducted a targeted review of relevant literature and applied a health financing framework to analyse the benefit packages available in each government-sponsored scheme. We found considerable heterogeneity in country approaches to diagnostics. Of the seven countries, only India has developed a national essential diagnostics list. No country presented a clear policy rationale on the inclusion of diagnostics in their scheme and the level of detail on the specific diagnostics which are covered under the schemes was also generally lacking. Government-sponsored insurance expansion in the eligible populations has reduced the out-of-pocket health payment burden in many of the countries but overall, there is a lack of access, availability and affordability for diagnostic-related services.
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spelling pubmed-103641572023-07-25 The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam Bigio, Jacob Hannay, Emma Pai, Madhukar Alisjahbana, Bachti Das, Rishav Huynh, Huy Ba Khan, Uzma Mortera, Lalaine Nguyen, Thu Anh Safdar, Muhammad Aamir Shrestha, Suvesh Venkat Raman, A Verma, Sharat Chandra Yellappa, Vijayashree Srivastava, Divya BMJ Glob Health Practice The Lancet Commission on Diagnostics highlighted a huge gap in access to diagnostic testing even for basic tests, particularly at the primary care level, and emphasised the need for countries to include diagnostics as part of their universal health coverage benefits packages. Despite the poor state of diagnostic-related services in low-income and middle-income countries (LMICs), little is known about the extent to which diagnostics are included in the health benefit packages. We conducted an analysis of seven Asian LMICs—Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, Viet Nam—to understand this issue. We conducted a targeted review of relevant literature and applied a health financing framework to analyse the benefit packages available in each government-sponsored scheme. We found considerable heterogeneity in country approaches to diagnostics. Of the seven countries, only India has developed a national essential diagnostics list. No country presented a clear policy rationale on the inclusion of diagnostics in their scheme and the level of detail on the specific diagnostics which are covered under the schemes was also generally lacking. Government-sponsored insurance expansion in the eligible populations has reduced the out-of-pocket health payment burden in many of the countries but overall, there is a lack of access, availability and affordability for diagnostic-related services. BMJ Publishing Group 2023-07-21 /pmc/articles/PMC10364157/ /pubmed/37479500 http://dx.doi.org/10.1136/bmjgh-2023-012512 Text en © World Health Organization 2023. Licensee BMJ. https://creativecommons.org/licenses/by-nc/3.0/igo/This is an open access article distributed under the terms of the Creative Commons Attribution IGO License (CC BY NC 3.0 IGO (https://creativecommons.org/licenses/by-nc/3.0/igo/) ), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited. In any reproduction of this article there should not be any suggestion that WHO or this article endorse any specific organization or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article’s original URL.
spellingShingle Practice
Bigio, Jacob
Hannay, Emma
Pai, Madhukar
Alisjahbana, Bachti
Das, Rishav
Huynh, Huy Ba
Khan, Uzma
Mortera, Lalaine
Nguyen, Thu Anh
Safdar, Muhammad Aamir
Shrestha, Suvesh
Venkat Raman, A
Verma, Sharat Chandra
Yellappa, Vijayashree
Srivastava, Divya
The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam
title The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam
title_full The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam
title_fullStr The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam
title_full_unstemmed The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam
title_short The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam
title_sort inclusion of diagnostics in national health insurance schemes in cambodia, india, indonesia, nepal, pakistan, philippines and viet nam
topic Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10364157/
https://www.ncbi.nlm.nih.gov/pubmed/37479500
http://dx.doi.org/10.1136/bmjgh-2023-012512
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