Skip Navigation


Health Policy and Planning Advance Access originally published online on May 25, 2007
Health Policy and Planning 2007 22(4):246-262; doi:10.1093/heapol/czm015
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/4/246    most recent
czm015v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (4)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Noirhomme, M.
Right arrow Articles by Van Damme, W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Noirhomme, M.
Right arrow Articles by Van Damme, W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2007; all rights reserved.

Improving access to hospital care for the poor: comparative analysis of four health equity funds in Cambodia

Mathieu Noirhomme1,*, Bruno Meessen2, Fred Griffiths3, Por Ir4, Bart Jacobs5, Rasoka Thor6, Bart Criel2 and Wim Van Damme2

1Institute of Tropical Medicine, Antwerp, Belgium, at the time of the research.
2Institute of Tropical Medicine, Antwerp, Belgium.
3Health Net International, Pearang, Cambodia.
4Belgian Technical Cooperation, Siem Reap, Cambodia.
5Swiss Red Cross, Cambodia.
6UNICEF, Cambodia.

* Corresponding author. 12 Rue Alexandre Desrousseaux, 59800 Lille, France. Mobile: +33 6 21 84 30 91. Tel: +33 3 20 53 25 84. E-mail: mathieunoirhomme{at}gmail.com

There is a large body of evidence that user fees in the health sector create exclusion. Health equity funds attempt to improve access to health care services for the poorest by paying the provider on their behalf.

This paper reviews four hospital-based health equity funds in Cambodia and draws lessons for future operations. It investigates the practical questions of ‘who should do what and how’. It presents, in a comparative framework, similarities and differences in objectives, the actors involved, design aspects and functional modalities between the health equity funds. The results of this review are presented along the lines of identification, hospitalization rates and relative costs.

The four schemes had a positive impact on the volume of utilization of hospital services by the poorest patients. They now account for 7 to 52% of total hospital use. The utilization of hospitals by paying patients has remained constant in the same period.

The comparative review shows that a range of operational arrangements may be adopted to achieve the health equity fund objectives. Our study identifies essential design aspects, and leaves different options open for others.

Key Words: User fees, poverty, access, waiver, utilization, health services

Accepted for publication 9 March 2007.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 BMJHome page
S. Taylor and A. Marandi
Social determinants of health and the design of health programmes for the poor
BMJ, July 9, 2008; 337(jul09_3): a290 - a290.
[Full Text]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.