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Améliorer La Couverture Effective En Matière de Santé: Les Incitations Financières Fonctionnent-Elles?
Paperback
ISBN13: 9781464818790
Publisher: World Bank Publications
Published: Oct 31 2022
Pages: 324
Weight: 1.70
Height: 0.84 Width: 7.50 Depth: 9.25
Language: French
Dans de nombreux pays à faible revenu et à revenu intermédiaire, la couverture sanitaire s'est considérablement améliorée au cours des deux dernières décennies, mais pas les résultats en matière de santé. Ainsi, la couverture effective - une mesure de la prestation de services qui répond à une norme minimale de qualité - demeure à un niveau inacceptable. Le rapport Améliorer la couverture effective en matière de santé examine une approche particulière visant à améliorer la couverture effective: les incitations financières sous la forme d'un financement basé sur la performance (FBP), une réforme globale qui comprend généralement la rémunération liée à la performance pour les agents de santé de première ligne ainsi que l'autonomie des établissements, la transparence et l'engagement communautaire.
Ce rapport de recherche s'appuie sur un vaste ensemble d'études rigoureuses et de nouvelles analyses. Par rapport au statu quo, dans les pays à faible revenu dotés de systèmes de santé centralisés, le FBP peut entraîner des gains substantiels en matière de couverture effective. Toutefois, les avantages relatifs du FBP - la composante rémunération liée à la performance en particulier - sont moins clairs lorsqu'il est comparé à deux autres approches, à savoir: le financement direct des établissements, qui permet d'octroyer des budgets de fonctionnement aux services de santé de première ligne en accordant aux établissements l'autonomie en matière d'allocations budgétaires, mais sans rémunération liée à la performance; et le soutien financier lié à la demande pour les services de santé (c'est-à -dire les transferts monétaires conditionnels et les vouchers). Bien que le FBP se traduise souvent par des améliorations marginales, combler les lacunes importantes de la couverture sanitaire effective n'est pas encore à la portée de nombreux pays. Néanmoins, d'importantes leçons et expériences tirées de la mise en oeuvre du FBP au cours de la dernière décennie peuvent orienter le financement de la santé à l'avenir. En particulier, pour réussir, la réforme du financement de la santé devra sans doute moins se focaliser sur la rémunération à la performance tout en conservant les éléments de financement direct des établissements, l'autonomie, la transparence et l'engagement communautaire.
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