הקצאת מקורות למימון סל הבריאות: בחינה מחדש של נוסחת הקפיטציה

הקצאת מקורות למימון סל הבריאות: בחינה מחדש של נוסחת הקפיטציה

מאת	לאה אחדות, עמיר שמואלי
מו"ל	הוצאת מכון ון ליר
שפה	עברית
שנת הוצאה	2015
סדרה	מפרסומי התוכנית לכלכלה וחברה

חוק ביטוח בריאות ממלכתי מפרט את מקורות המימון של עלות סל שירותי הבריאות שלו זכאי כל מבוטח ואת המנגנונים להקצאתם בין קופות החולים. המנגנון העיקרי שהחוק קבע הוא מנגנון הקפיטציה. זהו מנגנון להתאמת סיכון המיועד לפצות את הקופות במידה מספקת על ההוצאות לשירותי בריאות בשל צורכיהם הרפואיים של המבוטחים שלהן. נוסחת הקפיטציה הנוכחית כוללת את הגיל, את המין ואת הריחוק מהמרכז (פריפריה) כמתאמי סיכון. מחקר זה מבקש לבחון את השפעתם של משתנים חברתיים-כלכליים מצד הביקוש על ההוצאה של הקופות לשירותי בריאות – כאשר מובאים בחשבון גם משתנים דמוגרפיים ומשתני תחלואה – ולבדוק את היתכנות הכללתם של משתנים אלו בנוסחת ההקצאה.

על בסיס ממצאי המחקר החוקרים סבורים שיש לבחון את העשרת נוסחת הקפיטציה במתאמי סיכון חברתיים-כלכליים נוספים שאפשר ליצור ברמה הלאומית.

ניתן להוריד קובץ PDF של החוברת או להזמין את החוברת המודפסת (דמי משלוח בדואר: 10 ש"ח).

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עשוי לעניין אותך

לפרסומים נוספים

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