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An- Najah National University Faculty of Medicine Yazan Odeh. Health System Economics & Resources In Palestine & Israel. Outlines. Health Care Financing Health Care Expenditure Human & Physical Resources Problems facing Palestinian health system. Health Care Financing In Palestine.
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An-Najah National University Faculty of Medicine YazanOdeh Health System Economics & ResourcesIn Palestine & Israel
Outlines.. • Health Care Financing • Health Care Expenditure • Human & Physical Resources • Problems facing Palestinian health system
Health Care Financing In Palestine.. • Health system revenues include: • The International Aids: the main supporter for health system in Palestine • Public health insurance • Tax-based Financing :decreased in responding to the difficult economic situation with high percentage of unemployment. • Out-of-Pocket Payments :insured people pay cost sharing for drugs, lab, investigations and referral abroad cases.
25.3% of MOH running budget came from Governmental Health Insurance (GHI) premiums, and 3.82% from co-payment and fee revenues.
Health Care Financing In Israel.. • The NHI system is financed primarily from public sources – a mixed system of health tax and general tax revenue • Services outside the NHI system are financed via VHI, and direct out-of-pocket payments . • External financing sources such as donations from Jews in US and Europe often play an important role in funding health expenditure.
Health Care Expenditure In Palestine.. • In 2005, The budget for the MOH was $139,584,400, (7.65% of general budget). • Salaries represent 56% of MOH expenditure; whereas 18.6%, 15% and 10.4% cover Pharmaceuticals and medical needs, purchasing private medical services and non-medical expenditures, respectively.
Treatment Abroad represents a big burden for the Palestinian health system. The total cost of treatment abroad represented 46% of the actual expenditure in 2004 and 42.7% in 2005.
Health Care Expenditure In Israel.. • In 2005, Israel spent almost 43 billion NIS on health care, amounting to 7.8% of GDP.
Human & Physical Resources In Palestine.. • 57% of health human resources in Palestine are employed by MOH. • There are 9.73 physicians, 14.49 nurses, 1.43 pharmacists, and 17.5 administrators and workers per 10.000 populations in Palestine. • There are 0.47 physicians, and 0.74 nurses per hospital bed.
The total number of registered PHC centres in Palestine is 731centres (125 in the Gaza Strip and 606 in the West Bank). • Ministry of Health operates 56.5%of total PHC clinics in Palestine in 2004, UNRWA operates 7.3% and NGOs operates 36.2% . • There are 2.2 PHC centres per 10,000 populations.
Secondary care services are provided by 43 general hospitals with 3,539 beds. In addition to 10specialised hospitals with 813 beds, 20 maternity with 315 beds and finally four rehabilitation centres with 157 beds. • MOH owns and operates 61.1% of the general hospital beds and 70.4% of the specialised hospital beds. All rehabilitation centres are owned and operated by NGOs sector. • The total hospital bed/1000 population is 1.32 in 2004 in Palestine.
Human & Physical ResourcesIn Israel.. • There are 3.5 physicians, 5.8 nurses, .92 pharmacists, and 1.31 dentists per 1000 population in Israel. • In 2005, Israel had 47 general (acute) hospitals with 14 600 beds, 15 psychiatric hospitals with 4200 beds and 309 chronic disease hospitals with 21 800 beds. • The total hospital bed/1000 population is 2.1 in Israel.
Problems facing The Palestinian Health System: • Political Problems: • The main political obstacle is the occupation. • Apartheid Wall harms the health status of around 425,000 people (20% of West Bank residents). 41 clinics are located within 28 isolated areas and 38% of the Palestinians are deprived from health services due to the apartheid wall.
Financing problems: • Palestinian Healthcare financing is dependent on the external fund >> externally funded health projects focus on less important services ,such as large funds for family planning and too little for medications of the chronic diseases. • Referral abroad also consumes a great portion of the MOH budget.
Administrative inefficiency problems: • Salaries expenditure in the MOH increased from 45.35% out of the total MOH expenditures in 2000 to 52.4% in 2005; while non salaries expenditure decreased from 54.65% out of the total MOH expenditures in 2000 to 47.6% in 2005. This is caused in part by the great number of employees of administrative function without actual production.
References.. • www.who.int • www.moh.gov.ps • www.emro.who.int