Rapid Assessment of the Effect of the Economic Crisis on Health Spending in Mongolia

Rapid Assessment of the Effect of the Economic Crisis on Health Spending in Mongolia

This rapid assessment examines the effect of Mongolia's economic crisis on government health budgets and health expenditure, household out-of-pocket spending and donor health commitments. This study was part of a larger assessment conducted in...

Full description

Bibliographic Details
Main Authors:	Bredenkamp, Caryn, Sande Lie, Geir Sølve, Brenzel, Logan
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	AMBULATORY CARE ARTICLE BEDDING BEDS BUDGET ALLOCATION BUDGET ALLOCATIONS BUDGET DATA BUDGET DEFICIT BUDGET SAVINGS BUDGETARY ALLOCATION BUDGETARY ALLOCATIONS BUDGETARY PRESSURES CAPITA HEALTH EXPENDITURE CAPITAL EXPENSES CAPITAL INVESTMENT CAPITAL PROJECTS CAPITATION CATEGORIES OF EXPENDITURE CENTRAL ALLOCATION CENTRAL BUDGET CHILD HEALTH CLINICAL SERVICES COMMODITY PRICES COMMON COLD COMMUNICABLE DISEASES COST CONTROL CURRENCY DEVALUATION DATA COLLECTION DEBT DECISION-MAKING DEGREE OF COST-SHARING DEMAND FOR HEALTH DEMAND FOR HEALTH SERVICES DOCTORS DOMESTIC INVESTMENT DONOR AGENCIES DONOR ASSISTANCE DONOR FINANCING DONOR FUNDING DRUG CONSUMPTION ECONOMIC GROWTH ECONOMIC POLICIES ECONOMIC SHOCKS EQUITY OBJECTIVES EXCHANGE RATE EXPENDITURE DATA EXPENDITURES EXTERNAL FINANCING FINANCIAL CRISES FINANCIAL CRISIS FINANCIAL IMPACT FINANCIAL MANAGEMENT FINANCIAL PRESSURE FINANCIAL PROTECTION FINANCIAL SUPPORT FINANCIAL SYSTEM FINANCING OF HEALTH CARE FISCAL CAPACITY FISCAL CONTRACTION FISCAL DEFICIT FISCAL POSITION FISCAL PRESSURES FIXED COSTS FLAT RATE FOREIGN TRADE GOVERNMENT BUDGET GOVERNMENT BUDGETING GOVERNMENT BUDGETS GOVERNMENT EXPENDITURE GOVERNMENT REVENUES GOVERNMENT SPENDING HEALTH BUDGETS HEALTH CARE CENTERS HEALTH CARE DELIVERY HEALTH CARE DEMAND HEALTH CARE EXPENDITURE HEALTH CARE FACILITIES HEALTH CARE FINANCING HEALTH CARE NEEDS HEALTH CARE REFORM HEALTH CARE SPENDING HEALTH CARE SYSTEM HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH EXPENDITURE PER CAPITA HEALTH EXPENDITURES HEALTH FINANCING HEALTH INFORMATION HEALTH INFORMATION SYSTEM HEALTH INSURANCE HEALTH INSURANCE CONTRIBUTIONS HEALTH INSURANCE COVERAGE HEALTH INSURANCE FUND HEALTH INSURANCE FUNDS HEALTH INSURANCE SCHEME HEALTH MANAGEMENT HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH PROJECT HEALTH PROVIDERS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SERVICES HEALTH SERVICES RESEARCH HEALTH SPENDING HEALTH STATUS HEALTH SYSTEM HEALTH SYSTEM STRENGTHENING HEALTH SYSTEMS HEALTH SYSTEMS IN TRANSITION HEALTH SYSTEMS STRENGTHENING HEALTH WORKERS HEALTH WORKFORCE HIGH BLOOD PRESSURE HIV/AIDS HOSPITAL BEDS HOSPITAL BUDGETS HOSPITAL CARE HOSPITAL SECTOR HOSPITALS HOUSEHOLD EXPENDITURE HUMAN DEVELOPMENT HUMAN RESOURCES ILLNESS IMMUNIZATION INCOME INCOME COUNTRIES INCOME EFFECT INFANT MORTALITY INFANTS INFLATION INFLUENZA INFORMAL PAYMENTS INFORMAL SECTOR INFORMAL SECTOR WORKERS INPATIENT CARE INSURANCE PREMIUMS INVESTMENT EXPENDITURE KEY FISCAL INDICATORS MEDICAL SPECIALISTS MEDICAL SUPPLIES MEDICINES MIGRANTS MIGRATION MINISTRY OF FINANCE MINISTRY REPRESENTATIVES MORTALITY NATIONAL BUDGET NATIONAL BUDGETS NATIONAL HEALTH NATIONAL HEALTH EXPENDITURE NATURAL DISASTER NEEDS ASSESSMENT NUTRITION OPERATING EXPENSES ORAL HEALTH OUTPATIENT CARE OUTPATIENT SERVICES PATIENTS PAYMENT SYSTEM PERFORMANCE CRITERIA PHARMACEUTICAL COMPANIES PHARMACEUTICAL EXPENDITURES PHARMACY POVERTY IMPACT PREGNANT WOMEN PRIMARY CARE PRIMARY HEALTH CARE PRIVATE CONSUMPTION PRIVATE HOSPITALS PRIVATE PHARMACIES PRIVATE SECTOR PROGRAMS PROVIDER PAYMENT PSYCHOLOGY PUBLIC EXPENDITURE PUBLIC EXPENDITURE REVIEW PUBLIC HEALTH PUBLIC SECTOR PUBLIC SECTOR DEBT QUANTITATIVE DATA REHABILITATION REPRODUCTIVE HEALTH RESEARCH PROJECTS RESOURCE ALLOCATION SAFETY NETS SECTOR BUDGET SERVICE PROVISION SIZE OF GOVERNMENT SKIN DISEASES SOCIAL HEALTH INSURANCE SOCIAL INSURANCE SOCIAL PROTECTION SOCIAL SAFETY NETS SOCIAL SECURITY SOCIAL WELFARE STATE BUDGET TOTAL EXPENDITURE TOTAL PUBLIC SECTOR TRANSFER PAYMENTS TUBERCULOSIS UNEMPLOYMENT WAGE INCOME WASTE WORKERS
Online Access:	http://documents.worldbank.org/curated/en/2010/12/13260209/rapid-assessment-effect-economic-crisis-health-spending-mongolia http://hdl.handle.net/10986/13599

Description
Summary:	This rapid assessment examines the effect of Mongolia's economic crisis on government health budgets and health expenditure, household out-of-pocket spending and donor health commitments. This study was part of a larger assessment conducted in four countries on the effects of the economic crisis on health spending. A standardized approach was developed for all country case studies and consisted of a desk review of internationally-available literature and databases, extensive in-country review of data and documents available in government and donor offices, and semi-structured interviews with government staff, health providers and development partners. This assessment in Mongolia reveals a substantial reduction in the government health budget: the 2009 national health budget was significantly lower than the previous year's, and then was further reduced by 10 percent in a subsequent budget amendment. At national level, budget cuts were concentrated in investment line items. Among recurrent line items, the pharmaceutical budget was hardhit, but salaries were largely preserved, and there were no retrenchments. Similar patterns were observed at sub-national level for hospital budgets, which depend on the central allocations, but not for primary care facilities, which are funded on a capitation basis. Compared to other sectors, the health sector was relatively protected during the economic crisis and the share of health in the total government budget was higher after the budget amendment than before. To protect households from the effects of the economic crisis on health spending, the government undertook specific policy measures to expand health insurance coverage to vulnerable groups. Donor commitments to the health sector during the crisis largely tracked previously planned commitments.