Towards a suitable health insurance system in Syria: Options and the necessary procedures before implementation, based on qualitative analysis and international experiences [Elektronische Ressource] / Mania Mershed. Betreuer: Reinhard Busse

Mmershed

Informations

• Publié par: technische_universitat_berlin
• Publié le: 01 janvier 2011
• Nombre de lectures: 18
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Towards a suitable health insurance system in Syria:
Options and the necessary procedures before implementation,
based on qualitative analysis and international experiences


Vorgelegt von
Mania Mershed
Aus Swaida (Syrien)

Von der Fakultät VII - Wirtschaft und Management
– Institut für Technologie und Management –
Fachgebiet Management im Gesundheitswesen
der Technischen Universität Berlin
zur Erlangung des akademischen Grades
„Doktorin der Wirtschaftswissenschaften“
- Dr. rer. oec. -
genehmigte Dissertation


Promotionsausschuss:

Vorsitzender: Prof. Dr. Thomas Mansky
Berichter: Prof. Dr. Reinhard Busse
Berichter: Prof. Dr. Christian Gericke



Tag der wissenschaftlichen Aussprache: 22. 7. 2011




Berlin 2011
D83










































i
Contents


Figures and Tables ......................................................................................................... vi
Acknowledgment .......... viii
Zussamenfassung ........... ix
Summary ...................................................................................................................... xvii
Abbreviations ............. xxiv
1. Introduction .............. 1
Objectives .................... 3
The scope of the study ................................................................................................. 3
The structure of the thesis and thesis strategy ............................. 3
Methodology used ....... 4
2 Health Care Systems and Health Financing Functions ........ 6
2.1 What is a health system? ....................................................................................... 6
2.2 The major influences on health care systems ........................ 8
2.3 Health system functions 8
2.4 Financing of health care systems ........................................................................... 9
2.4.1 Health financing functions ............. 10
2.4.2 Models of health care systems based on the main source of their funding ... 27
3 The Current Syrian Health Care System ............................................................. 44
3.1 Background.......................................................................... 44
3.1.1 The geography and sociodemography ........................... 44
3.1.2 The economic context .................................................... 47
3.1.3 Health status ................................... 49
3.2 Organizational structure and management .......................... 53
3.3 Health financing functions .................................................. 56
3.3.1 Collection of Funds ........................................................ 59
3.3.2 Pooling of Funds ............................ 64
3.3.3 Purchasing health care services and health providers‟ payments .................. 66
3.4 Health care delivery system................................................. 68
3.4.1 Private providers of health care ..................................... 68
3.4.2 Philanthropic providers of health care ........................... 72
3.4.3 The health services provided by the government sector ................................ 72
3.4.4 Health human resources ................................................................................. 78
3.5 Health insurance in Syria ..................... 82
3.5.1 The health benefits schemes .......... 82
3.5.2 Private health insurance companies ............................................................... 86
3.5.3 The new health insurance law ........................................ 88
4 Interviews on the Current Health System and Future Health Insurance in
Syria ......................................................................................... 90
4.1 The qualitative data analysis method .................................. 90
4.1.1 The difference between qualitative and quantitative data analysis ................ 91
4.1.2 Theories and methods in qualitative data analysis ......................................... 91
4.1.3 Methods of collecting qualitative data ........................... 92
4.1.4 Why was the qualitative data analysis method selected? .............................. 93
4.2 Study design ........................................................................ 93
4.2.1 Defining the research questions ..................................... 93
4.2.2 Design of the interviews ................ 94
ii
4.2.3 Selecting the interviewees ............................................................................. 95
4.2.4 Data collection ............................................................... 99
4.3 Data Analysis....... 99
4.3.1 Transcription .................................................................. 99
4.3.2 Translation ..... 99
4.3.3 Familiarization ............................................................. 100
4.3.4 Identifying a thematic framework 100
4.3.5 Coding .......................................................................... 100
4.3.6 Charting ....................................... 100
4.3.7 Interpretation 101
4.4 The results ......... 101
4.4.1 Interview 1 ................................................................... 101
4.4.2 Interview 2 ................................... 107
4.4.3 Interview 3 ... 112
4.4.4 Interview 4 ... 116
4.4.5 Interview 5 ................................................................... 120
4.4.6 Interview 6 ................................... 125
4.4.7 Interview 7 ... 129
4.4.8 Interview 8 ... 133
4.4.9 Interview 9 ................................................................... 138
4.4.10 Interview 10 ............................................................... 142
4.4.11 Interview 11 147
4.4.12 Interview 12 150
4.4.13 Interview 13 ................................ 155
4.4.14 Interview 14 ............................................................... 159
4.4.15 Interview 15 163
4.4.16 Interview 16 168
4.4.17 Interview 17 ................................ 172
4.4.18 Interview 18 ............................................................... 175
4.4.19 Interview 19 181
4.5 Comparison of interviews results ...................................... 185
5 Other Health Care Systems and Lessons Learnt ............... 207
5.1 Criteria of selecting the countries studied ......................................................... 207
5.2 National Social Health Insurance System in Colombia .... 212
5.2.1 Historical background .................................................. 212
5.2.2 The major reforms of the health care system ............................................... 213
5.2.3 The structure of the National Social Health Insurance System ................... 214
5.2.4 Extending population coverage and the basis for entitlement ..................... 215
5.2.5 Health financing function ............................................ 217
5.2.6 The benefits packages .................................................. 222
5.2.7 Lessons that can be learned from the experience of Colombia ................... 223
5.3 The Social Health Insurance system (SHI) in Germany ................................... 225
5.3.1 Historical background .................................................. 225
5.3.2 The major reforms of the health system ...................................................... 227
5.3.3 The structure of German Social Health Insurance ....... 228
5.3.4 Extending population coverage and the basis for entitlement ..................... 229
5.3.5 Health financing functions ........................................................................... 231
5.3.6 The benefits package ................... 239
5.3.7 Lessons that can be learned from the experience of Germany .................... 240
iii
5.4 The Social Health Insurance System in Romania ............................................. 242
5.4.1 Historical background .................................................. 242
5.4.2 The major reforms of the Social Health Insurance system .......................... 243
5.4.3 The structure of the Social Health Insurance system ................................... 244
5.4.4 Extending population coverage and the basis for entitlement ..................... 245
5.4.5 Health financing functions ........................................... 246
5.4.6 The benefits package ................................................... 253
5.4.7 Lessons that can be learned from the Romanian experience ....................... 254
5.5 The National Health Insurance System in South Korea .................................... 255
5.5.1 Historical background .................................................. 255
5.5.2 The major reforms in the Korean National Health Insurance system .......... 258
5.5.3 The structure of the National Health Insurance system ............................... 259
5.5.4 Extending population coverage and the basis for entitlement ..........