This book explores the implications of a wide range of intergovernmental fiscal arrangements found in fiscal federal systems and how they impact on the equitable distribution of primary health care resources. The issues raised in the book are relevant to all countries operating under a fiscal federal system and those that operate a decentralized health system.

A timely exploration of the allocation of resources

This manual is designed to provide primary health care program managers with guidance on how to use cost analysis and cost-effectiveness analysis as tools to achieve better understanding and management of resource flows. Although it has been prepared primarily for program managers at national, regional, and district levels, other health professionals can learn from it through a short training course or by individual study. Part A introduces unit financial costs and provides a first look at the effectiveness of health services, in six modules: what costs are, using cost data, planning the study, calculating costs, measuring effectiveness, and calculating unit financial costs. Part B covers other kinds of costs and compares costs and effectiveness estimates. Topics of the three modules are as follows: measuring and using economic costs, household costs, and cost-effectiveness analysis. In part C, several important uses of cost and cost-effectiveness data for planning and management are discussed and illustrated. Future costs, financial analysis, and managerial efficiency are the topics of the three modules. A set of exercises to be used with the individual modules follow. Appendixes contain the following: annualization factors; 10 resources for further reading, including guidelines and methods and case studies; and an index. (YLB)

The global health community is broadly in agreement that achievement of the health-related Sustainable Development Goals (SDGs) hinges upon both an escalation of the financial resources dedicated to primary health care (PHC) and a more effective use of those resources: more money, better spent. This book introduces and explicates the end-to-end resource tracking and management (RTM) framework, which includes five components that determine effective and efficient financing for PHC: resource mobilization, allocation, utilization, productivity, and targeting.In addition, this book compiles detailed results from the most recent RTM-based resource tracking efforts for PHC in selected countries. This is to demonstrate how the RTM framework can be used to bring a set of separate resource tracking efforts at different stages of flow of funds into a comprehensive process with an end-to-end 'storyline'. In order to build a functional PHC system that addresses access, quality, and equity issues, this book highlights the key (public) financing issues that researchers, technical advisors, and policy makers would need to address in addition to more resources.

This report is the first of its kind to measure health service coverage and financial protection to assess countries' progress towards universal health coverage. It shows that at least 400 million people do not have access to one or more essential health services and 6% of people in low- and middle-income countries are tipped into or pushed further into extreme poverty because of health spending. Universal health coverage (UHC) means that all people receive the quality essential health services they need without being exposed to financial hardship. A significant number of countries at all levels of development are embracing the goal of UHC as the right thing to do for their citizens. It is a powerful social equalizer and contributes to social cohesion and stability. Every country has the potential to improve the performance of its health system in the main dimensions of UHC: coverage of quality services and financial protection for all. Priorities strategies and implementation plans for UHC will differ from one country to another. Enhanced and expanded monitoring of health under the Sustainable Development Goals (SDGs) should seek to build on that experience sharpening our focus on the key health service and financial protection interventions that underpin UHC. Effective UHC tracking is central to achieving the global goals for poverty alleviation and health improvement set by the World Bank Group and WHO. Without it policymakers and decision-takers cannot say exactly where they are or set a course for where they want to go. They cannot know whether they are focussing their efforts in the right areas or whether their efforts are making a difference. Monitoring is thus fundamental to the achievement of UHC objectives. It will also be vital to the realization of the SDGs. This report is a critical step to show how monitoring progress can be done telling us what the state of coverage of interventions and financial protection is and telling us where to focus most.

Quality is at the heart of the government's strategy for NHS development, and which is to be delivered through clinical governance. This book explores accreditation through practical case studies and research findings, and outlines how it can assure the quality of care. Systems of accreditation for measuring and improving quality are described, and show how they can be used easily and effectively to meet the challenges of the new NHS. It is clear, concise and relevant to all the current changes in healthcare provision. All those responsible for delivering a service based on clinical and cost effectiveness will find it essential reading. 'In the United Kingdom primary health care is based almost wholly on general practice. From April 1999 all general practices will belong to primary care groups. Questions of quality and accountability will be high on their agenda as part of the new arrangements for clinical governance. This book on accreditation in primary care is therefore most timely.' Sir Donald Irvine, President, General Medical Council, in the Introduction.

The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.