Live SessionModule 6
Module Title: Financing Health Systems
HCM500
Healthcare Systems
Instructor Name
Module 6 Learning Outcomes
1. Assess the types of reimbursement systems designed for
the delivery of healthcare.
2. Analyze the growth of national healthcare expenditures
and regulatory cost measures.
3. Examine how insurance finances healthcare in different
countries.
4. Differentiate between single and multi-payer systems.
5. Assess types of reimbursement systems designed for the
delivery of healthcare.
6. Evaluate the impact of Universal Healthcare and
Financing.
HCM500 Healthcare Systems
Global Funding Mechanisms for
Healthcare
• General Taxation
• Required Social
Insurance
• Private Insurance
• Out-of-pocket Payment
• External Aid
HCM500 Healthcare Systems
Role of Government in Financing
Healthcare
•Compulsory Social Insurance
•National Health Insurance (NHI)
•National Health System
HCM500 Healthcare Systems
Role of Government in Financing Healthcare
HCM500 Healthcare Systems
Role of Government in Financing Healthcare
Current health
expenditure per capita
(in US Dollars)
Domestic general government
health expenditure (as a
percentage of Gross Domestic
Product)
Current Health Expenditure
by Revenue Source –
Domestic Public
$1,147
3.9%
68%
Egypt
$131
1.4%
29%
Jordan
$224
4%
63%
Turkey
$469
4%
78%
Germany
$4,714
10%
85%
United Kingdom
$3,958
8%
80%
United States of America
$9,870
14%
82%
Country
Saudi Arabia
HCM500 Healthcare Systems
Insurance and Healthcare Costs
• Insurance is a mechanism
for distributing and reducing
risk
• Tension between consumers
who want low premiums
and;
• Restrictions on coverage
placed by insurance
companies.
HCM500 Healthcare Systems
Insurance and Healthcare Costs
• Services Covered
• Out-of-pocket requirements
• Preexisting condition limitations
• Pre-authorization requirements.
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Rising Expenditures
•Lifestyle changes in KSA
•Developed nations and chronic illness
•Longer life expectancy
•Higher healthcare costs
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Expenditure on Non-Communicable Diseases
in KSA
• Billions spent on
diabetes treatment
• Direct and indirect costs
• Prevention is key
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Saudi Health Interview Survey Results:
Cholesterol
•Cholesterol is 11th
ranked risk factor for
disability adjusted
life years in KSA
•Prevalence of
elevated cholesterol
-9.5% males and
7.3% females (SHIS,
2013)
HCM500 Healthcare Systems
Saudi Health Interview Survey Results:
Diabetes
•Diabetes is very
prevalent in KSA
•14.8% for males
•11.7% for females
•Associated with
coronary artery
disease and
atherosclerosis(SHIS,
2013)
HCM500 Healthcare Systems
Saudi Health Interview Survey Results:
Hypertension
•Hypertension
prevalence is quite
high in KSA
•17.7% males
•12.5% females
•Associated with risk
for atherosclerosis
and aneurysm(SHIS,
2013)
HCM500 Healthcare Systems
Saudi Health Interview Survey Results
•Obesity is very
prevalent in KSA
•33.5% females
•24.1% males
•Obesity is associated
with higher risk of
cardiovascular
diseases, diabetes,
sleep apnea.
HCM500 Healthcare Systems
Module 6 Assignment Requirements
• Discussion Board on Healthcare Financing in
KSA
HCM500 Healthcare Systems
References
• Alqarni, A. M., Alrahbeni, T., Al Qarni, A., & Al Qarni, H. M. (2019). Adherence to diabetes medication among
diabetic patients in the Bisha governorate of Saudi Arabia – a cross-sectional survey. Patient Preference and
Adherence, 13, 63–71.
• Colliers International. (2018). The pulse: 8th edition: Kingdom of Saudi Arabia healthcare overview 2018.
Retrieved from https://www.colliers.com/-/media/files/emea/uae/case-studies/2018-overview/ksa-healthcareoverview-thepulse-8th-edition.pdf?la=en-gb
• International Diabetes Federation. (n.d.). IDF MENA members. Retrieved from https://www.idf.org/ournetwork/regions-members/middle-east-and-north-africa/members/46-saudi-arabia.html
• Institute for Health Metrics and Evaluation [IHME]. (n.d.). Estimating health expenditure in the Kingdom of
Saudi Arabia. Retrieved from http://www.healthdata.org/ksa/projects/estimating-health-expenditure
• Organisation for Economic Co-operation and Development (OECD). (2015). How does health spending in Turkey
compare? Retrieved from https://www.oecd.org/els/health-systems/Country-Note-TURKEY-OECD-HealthStatistics-2015.pdf
• Rodwin, V. (2019). The French health care system. World Hospitals and Health Services – Universal Health
Coverage (UHC): Making progress towards the 2030 targets, 54(1), 49-55.
• Shi, L., & Singh, D. A. (2014). Delivering healthcare in America: A systems approach (6th ed.). Sudbury, MA:
Jones & Bartlett Publishers.
• World Health Organization. (2012). Health systems in the Eastern Mediterranean Region: Situation, challenges
and gaps, priorities and WHO contribution. Retrieved from
https://apps.who.int/iris/bitstream/handle/10665/116086/High_Level_Exp_Meet_Rep_2012_EN_14496.pdf?se
quence=1
• World Health Organization (WHO). (2019). Global health expenditure database. Retrieved from:
http://apps.who.int/nha/database/country_profile/Index/en
HCM500 Healthcare
Systems
Questions
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