Financing Health Systems

By Zeena Johar, President – ICTPH

The fundamental step towards achieving health equity is universal coverage, i.e., universal access to the full range of personal and non-personal health services including social health protection. My previous paper ICTPH Health Systems Approach detailed our vision for primary healthcare using three dimensions of technology, human resources and infrastructure. This paper now attempts to assign costs to each of these three dimensions in the context of the Pattukkottai block of the Thanjavur district of Tamil Nadu based on the experiences of SughaVazhvu Healthcare – a programme partner of ICTPH.

Kaiser Permanente (KP) the largest non-profit health plan in the United States closely coordinates primary, secondary, and hospital care, placing a strong emphasis on prevention and extensive use of ‘care pathways’ and electronic medical records (EMR). ‘Care Pathways’ at KP, as developed by multidisciplinary teams, uses evidence-based medicine to facilitate integrated care. The KP vision is closer to the overall health-systems vision of ICTPH and this paper makes an attempt also then to compute what the overall cost of such an integrated model would look like. It uses its estimates from Pattukkottai to assess both costs of primary care as well as the actual disease burden and then combines that with estimated insurance premiums to arrive at the cost of integrated care.

Download the paper here.