Republic of Uruguay Integrated National Health System : Analysis of the Governability of the SNIS Benefit Plan
Today the health reform in Uruguay is a mature, ongoing process in which major progress has been consolidated. At the same time, like all systems, it faces challenges in the immediate, medium, and long term, and how they are resolved will not only...
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| Format: | Other Health Study |
| Language: | English en_US |
| Published: |
Washington, DC
2014
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| Online Access: | http://documents.worldbank.org/curated/en/2012/11/18286242/uruguay-integrated-national-health-system-analysis-governability-snis-benefit-plan-piass http://hdl.handle.net/10986/16794 |
| Summary: | Today the health reform in Uruguay is a
mature, ongoing process in which major progress has been
consolidated. At the same time, like all systems, it faces
challenges in the immediate, medium, and long term, and how
they are resolved will not only shape the ultimate outcome
of many of the processes currently under way, and but will
also impact the sustainability of the accomplishments so
far. The purpose of this study is to contribute to
development of the integrated national health system (SNIS)
by analyzing and identifying policy options aimed at
improving its governance, equity, efficiency, and
sustainability through the government's use of control
variables in order to achieve and maintain conditions of
governability and efficiency, which will contribute to the
stability and sustainability of the results. The present
study analyzes the main variables that Uruguay has at its
disposal to manage a central aspect of regulating the sector
namely, the plan of benefits that the population receives to
cover their health needs. This plan has important
consequences for both health and the economy. The specific
objectives of the study were to analyze the following three
aspects of the SNIS: (i) the conditions of governance and
governability of its benefit plan, (ii) methodological
aspects of determining the premium to be received by
insurers, and (iii) the capacity of the management
information systems that are being used to monitor and
evaluate the benefit plan. The document has three sections:
(i) background; (ii) health coverage: critical aspects that
affect its governability, specifically: (a) the benefit plan
and the conditions of its governance, (b) the methodologies
used to determine the premium, and (c) the health
information systems used to monitor and evaluate the benefit
plan; and (iii) conclusions and policy options. Finally,
there are seven annexes that provide details on the topics discussed. |
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