UDC 368.9.06(477)
Bas-Yurchyshyn, M. A. (2015). Orhanizatsiyni osoblyvosti finansuvannya sfery okhorony zdorov’ya u sil's'kiy mistsevosti na pryntsypakh medychnoho strakhuvannya [Organizational peculiarities of financing healthcare in rural areas based on health insurance]. Rehional'na ekonomika - Regional Economy, 77(3). [in Ukrainian].
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Authors

Resume

The main characteristics of the health insurance organization in rural areas are determined in the article, namely the number and age structure of the population; the remoteness of the village from the district or regional center; medical infrastructure; the number and major types of diseases; income levels; key areas of rural employment; channels of access to information and mentality of residents of rural areas. The prerequisites for reforming health care financing system and the introduction of health insurance in rural areas are identified: lack of adequate quantity and quality of public health care; poor availability of qualitative medical care and the high cost of transporting the patient to the hospital; the prevalence of the population with low incomes; low level culture of consumption of medical services; the absence of a comprehensive accounting system morbidity countryside. The three phases algorithm of health insurance service is outlined, according to which, the measures to organize health insurance system in some rural areas are proposed to implement. This arrangement should be implemented under the scheme, which, depending on the voluntary or obligatory form of health insurance consists of the following aspects: the content of the program; its value; representative of the insurer in the settlement; accounting system and marketing. In the first phase of the algorithm it is offered to form health insurance programs, to determine their prices and to secure the representation of insurance companies in the region. Programs must include a list of essential services defined by the legislation, taking into account the region risk, determining the optimum area to reach hospital and healthcare institutions for cooperation. Cost of the program depends on the level of health of the insured, individual risks and risks of certain rural areas. Representation of insurer under obligatory health insurance system is provided by the personnel potential of rural territory and the availability of consultants in each locality. Representation for insurers in the voluntary health insurance system depends on the number of customers in a particular locality. The second phase is to provide regional coverage by doctors-coordinators of the insured persons, considering optimum area to reach to the patient. Also it is important to develop the telemedicine and the availability of continuous monitoring of changes in rural areas by defined parameters in a single integrated accounting system. In the third phase organizational mechanism requires the implementation of marketing activities, which include the study of population attitude in rural areas to health insurance services. The ultimate goal of marketing activities of insurers is to create value to the insured persons, which they will get from health insurance.

Keywords:

health insurance, rural areas, obligatory health insurance, voluntary health insurance