Cross-border medical travels from Cambodia: pathways to care, associated costs and equity implications.

Abstract:

:In low- and middle-income countries, patients may travel abroad to seek better health services or treatments that are not available at home, especially in regions where great disparities exist between the standard of care in neighbouring countries. While awareness of South-South medical travels has increased, only a few studies investigated this phenomenon in depth from the perspective of sending countries. This article aims to contribute to these studies by reporting findings from a qualitative study of medical travels from Cambodia and associated costs. Data collection primarily involved interviews with Cambodian patients returning from Thailand and Vietnam, conducted in 2017 in the capital Phnom Penh and two provinces, and interviews with key informants in the local health sector. The research findings show that medical travels from Cambodia are driven and shaped by an interplay of socio-economic, cultural and health system factors at different levels, from the effects of regional trade liberalization to perceptions about the quality of care and the pressure of relatives and other advisers in local communities. Furthermore, there is a diversity of medical travels from Cambodia, ranging from first class travels to international hospitals in Bangkok and cross-border 'medical tourism' to perilous overland journeys of poor patients, who regularly resort to borrowing or liquidating assets to cover costs. The implications of the research findings for health sector development and equitable access to care for Cambodians deserve particular attention. To some extent, the increase in medical travels can stimulate improvements in the quality of local health services. However, concerns remain that these developments will mainly affect high-cost private services, widening disparities in access to care between population groups.

journal_name

Health Policy Plan

authors

Liverani M,Ir P,Jacobs B,Asante A,Jan S,Leang S,Man N,Hayen A,Wiseman V

doi

10.1093/heapol/czaa061

subject

Has Abstract

pub_date

2020-10-01 00:00:00

pages

1011-1020

issue

8

eissn

0268-1080

issn

1460-2237

pii

5892998

journal_volume

35

pub_type

杂志文章
  • Increasing contraceptive use in rural Pakistan: an evaluation of the Lady Health Worker Programme.

    abstract::Past efforts to promote family planning in Pakistan have been disappointing, but between 1990-91 and 2000-01 contraceptive use has more than doubled. This rise has coincided with a concerted effort on the part of the Pakistani government to increase access to contraceptive services, particularly in rural areas. The La...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czi014

    authors: Douthwaite M,Ward P

    更新日期:2005-03-01 00:00:00

  • Treatment as insurance: HIV antiretroviral therapy offers financial risk protection in Malawi.

    abstract::Many countries have expanded insurance programmes in an effort to achieve universal health coverage (UHC). We assess a complementary path toward financial risk protection: increased access to technologies that improve health and reduce the risk of large health expenditures. Malawi has provided free HIV treatment since...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa023

    authors: Dickerson S,Baranov V,Bor J,Barofsky J

    更新日期:2020-07-01 00:00:00

  • Socio-economic and ethnic group inequities in antenatal care quality in the public and private sector in Brazil.

    abstract:BACKGROUND:Socio-economic inequalities in maternal and child health are ubiquitous, but limited information is available on how much the quality of care varies according to wealth or ethnicity in low- and middle-income countries. Also, little information exists on quality differences between public and private provider...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czp065

    authors: Victora CG,Matijasevich A,Silveira M,Santos I,Barros AJ,Barros FC

    更新日期:2010-07-01 00:00:00

  • Demand for voluntary basic medical insurance in urban China: panel evidence from the Urban Resident Basic Medical Insurance scheme.

    abstract::This paper investigates the key factors associated with the demand for Urban Resident Basic Medical Insurance (URBMI), which was established in 2007 and aims to cover all Chinese urban residents. Two waves of longitudinal household survey data are used, and a three-level random-intercept logit model is used for the an...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs014

    authors: Chen G,Yan X

    更新日期:2012-12-01 00:00:00

  • A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings.

    abstract::BACKGROUND A recent situational analysis suggests that post-apartheid South Africa has made some gains with respect to the decentralization and integration of mental health into primary health care. However, service gaps within and between provinces remain, with rural areas particularly underserved. Aim This study aim...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr012

    authors: Petersen I,Lund C,Bhana A,Flisher AJ,Mental Health and Poverty Research Programme Consortium.

    更新日期:2012-01-01 00:00:00

  • Equity in coverage of maternal and newborn care in India: evidence from a nationally representative survey.

    abstract::Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health Survey (NFHS-4) data to assess the socio-economic inequities in ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa020

    authors: Krishnamoorthy Y,Majella MG,Rajaa S

    更新日期:2020-06-01 00:00:00

  • Lessons learned from bednet distribution in Central Mozambique.

    abstract:INTRODUCTION:Malaria is an important cause of mortality and morbidity in sub-Saharan Africa. Use of insecticide-treated bednets (ITNs) is an important preventive intervention. Selection of the best mechanisms for distribution and promotion of ITNs to vulnerable populations is an important strategic issue. METHODS:Comm...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czm002

    authors: Brentlinger PE,Correia MA,Chinhacata FS,Gimbel-Sherr KH,Stubbs B,Mercer MA

    更新日期:2007-03-01 00:00:00

  • Catastrophic and impoverishing effects of health expenditure: new evidence from the Western Balkans.

    abstract::This paper investigates the effect of health-related expenditure on household welfare in Albania, Bosnia and Herzegovina, Montenegro, Serbia and Kosovo, all of which have undertaken major health sector reform. Two methodologies are used: (i) the incidence and intensity of 'catastrophic' health care expenditure, and (i...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czq070

    authors: Bredenkamp C,Mendola M,Gragnolati M

    更新日期:2011-07-01 00:00:00

  • What does quality maternity care mean in a context of medical pluralism? Perspectives of women in Nigeria.

    abstract::User priorities regarding quality care in contexts of medical pluralism are poorly documented. Drawing on group and individual interviews with women, we interrogate ideas of quality maternity care in the context of Nigeria's medical pluralism. We found complex utilization patterns for conventional, complementary and a...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czx131

    authors: Izugbara CO,Wekesah F

    更新日期:2018-01-01 00:00:00

  • Improving access for the poorest to public sector health services: insights from Kirivong Operational Health District in Cambodia.

    abstract::This article presents research findings into the effectiveness of an innovative equity fund approach to improving access to public sector health services for the poor in Kirivong Operational Health District in Cambodia. The operational health district is the lowest organizational level in the Cambodian health system, ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czj001

    authors: Jacobs B,Price N

    更新日期:2006-01-01 00:00:00

  • Information quality in a remote rural maternity unit in Ghana.

    abstract::The collection of accurate maternal outcome data enables causes of morbidity and mortality to be identified, which in turn permits interventions to be targeted appropriately. It also allows estimates to be made about the importance of various indicators in predicting birth outcome. These indicators can then be compare...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/15.2.170

    authors: Allotey PA,Reidpath D

    更新日期:2000-06-01 00:00:00

  • Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia.

    abstract::Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv072

    authors: Mayston R,Alem A,Habtamu A,Shibre T,Fekadu A,Hanlon C

    更新日期:2016-04-01 00:00:00

  • Scaling-up essential neuropsychiatric services in Ethiopia: a cost-effectiveness analysis.

    abstract:INTRODUCTION:There is an immense need for scaling-up neuropsychiatric care in low-income countries. Contextualized cost-effectiveness analyses (CEAs) provide relevant information for local policies. The aim of this study is to perform a contextualized CEA of neuropsychiatric interventions in Ethiopia and to illustrate ...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czv093

    authors: Strand KB,Chisholm D,Fekadu A,Johansson KA

    更新日期:2016-05-01 00:00:00

  • Infant-feeding practices of mothers of known HIV status in Lusaka, Zambia.

    abstract:BACKGROUND:Between 25 and 44% of mother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) occurs through breastfeeding. As a result, feeding guidelines for infants of HIV-infected mothers are being formulated in many resource-poor countries. The impact of introducing these guidelines on mothers' ac...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czg020

    authors: Omari AA,Luo C,Kankasa C,Bhat GJ,Bunn J

    更新日期:2003-06-01 00:00:00

  • Effect of a prospective payment method for health facilities on direct medical expenditures in a low-resource setting: a paired pre-post study.

    abstract::Almost all sub-Saharan countries have adopted cost-reduction policies to facilitate access to health care. However, several studies underline the reimbursement delays experienced by health facilities, which lead to deficient implementation of these policies. In April 2016, for its free care policy, Burkina Faso shifte...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa039

    authors: Meda IB,Kouanda S,Dumont A,Ridde V

    更新日期:2020-08-01 00:00:00

  • Allocating scarce financial resources for HIV treatment: benchmarking prices of antiretroviral medicines in Latin America.

    abstract::Public sector price analyses of antiretroviral (ARV) medicines can provide relevant information to detect ARV procurement procedures that do not obtain competitive market prices. Price benchmarks provide a useful tool for programme managers and policy makers to support such planning and policy measures. The aim of the...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czs011

    authors: Wirtz VJ,Santa-Ana-Tellez Y,Trout CH,Kaplan WA

    更新日期:2012-12-01 00:00:00

  • Exploring referral systems for injured patients in low-income countries: a case study from Cambodia.

    abstract::Injury is a growing public health concern worldwide. Since severe injuries require urgent treatment, involving smooth, timely patient referral between facilities, strengthening of the referral system would reduce injury mortality. Smooth referral consists of identification of severe cases, organization of transportati...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czp063

    authors: Nakahara S,Saint S,Sann S,Ichikawa M,Kimura A,Eng L,Yoshida K

    更新日期:2010-07-01 00:00:00

  • Career intentions of medical students in the setting of Nepal's rapidly expanding private medical education system.

    abstract::The number of medical students trained in Nepal each year has increased nearly fifty-fold in the last 15 years, primarily through the creation of private medical schools. It is unknown where this expanding cohort of new physicians will ultimately practice. We distributed an anonymous survey to students in their last 2...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr052

    authors: Huntington I,Shrestha S,Reich NG,Hagopian A

    更新日期:2012-08-01 00:00:00

  • The progressivity of health-care financing in Kenya.

    abstract:BACKGROUND:Health-care financing should be equitable. In many developing countries such as Kenya, changes to health-care financing systems are being implemented as a means of providing equitable access to health care with the aim of attaining universal coverage. Vertical equity means that people of dissimilar ability t...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czt073

    authors: Munge K,Briggs AH

    更新日期:2014-10-01 00:00:00

  • Health policy evolution in Lao People's Democratic Republic: context, processes and agency.

    abstract::During the last 20 years Lao People's Democratic Republic has successfully developed and adopted some 30 health policies, strategies, decrees and laws in the field of health. Still, the implementation process remains arduous. This article aims at discussing challenges of health policy development and effective impleme...

    journal_title:Health policy and planning

    pub_type: 杂志文章,评审

    doi:10.1093/heapol/czu017

    authors: Jönsson K,Phoummalaysith B,Wahlström R,Tomson G

    更新日期:2015-05-01 00:00:00

  • 'Seeking affluent neighbourhoods?' a time-trend analysis of geographical distribution of hospitals in the Megacity of Tehran.

    abstract:Objective:Access to hospitals in megacities in low and middle income countries might be hampered by travel barriers and distance. We assessed the 'inverse care law' hypothesis: whether hospitals tended to be built in the relatively better-off areas through the time. Methods:A longitudinal time-series study (1966 to 20...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czw172

    authors: Chavehpour Y,Rashidian A,Raghfar H,Emamgholipour Sefiddashti S,Maroofi A

    更新日期:2017-06-01 00:00:00

  • 'One health' and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia.

    abstract::'One World, One Health' has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of tra...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu001

    authors: Mwacalimba KK,Green J

    更新日期:2015-03-01 00:00:00

  • Supervision of community health nurses in Ghana: a mixed-methods study on experiences and mentorship needs.

    abstract::Adequate supervision is critical to maintain the performance of health workers who provide essential maternal and child health services in low-resource areas. Supportive supervision emphasizing problem-solving, skill development and mentorship has been shown to improve the motivation and effectiveness of health worker...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czaa167

    authors: Bellerose M,Alva S,Magalona S,Awoonor-Williams K,Sacks E

    更新日期:2020-12-22 00:00:00

  • Does household enrolment reduce adverse selection in a voluntary health insurance system? Evidence from the Ghanaian National Health Insurance System.

    abstract::In August 2003, the Ghanaian Government made history by implementing the first National Health Insurance System (NHIS) in sub-Saharan Africa. Within 2 years, over one-third of the country had voluntarily enrolled in the NHIS. To discourage households from selectively enrolling their sickest (high-risk) members, the NH...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czr057

    authors: Rajkotia Y,Frick K

    更新日期:2012-08-01 00:00:00

  • The state of diet-related NCD policies in Afghanistan, Bangladesh, Nepal, Pakistan, Tunisia and Vietnam: a comparative assessment that introduces a 'policy cube' approach.

    abstract::We assessed the technical content of sugar, salt and trans-fats policies in six countries in relation to the World Health Organization 'Best Buys' guidelines for the prevention and control of non-communicable diseases (NCDs). National research teams identified policies and strategies related to promoting healthy diets...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czz175

    authors: Buse K,Aftab W,Akhter S,Phuong LB,Chemli H,Dahal M,Feroz A,Hofiani S,Pradhan NA,Anwar I,Skhiri HA,El Ati J,Giang KB,Puri M,Noormal B,Rabbani F,Hawkes S

    更新日期:2020-06-01 00:00:00

  • Costs and cost-effectiveness of a mental health intervention for war-affected young persons: decision analysis based on a randomized controlled trial.

    abstract:BACKGROUND:One billion children live in war-affected regions of the world. We conducted the first cost-effectiveness analysis of an intervention for war-affected youth in sub-Saharan Africa, as well as a broader cost analysis. METHODS:The Youth Readiness Intervention (YRI) is a behavioural treatment for reducing funct...

    journal_title:Health policy and planning

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/heapol/czv078

    authors: McBain RK,Salhi C,Hann K,Salomon JA,Kim JJ,Betancourt TS

    更新日期:2016-05-01 00:00:00

  • Assessing the impact of budget controls on the prescribing behaviours of physicians treating dialysis-dependent patients.

    abstract:OBJECTIVES:This study examined whether outpatient haemodialysis providers changed their treatment practices with the establishment of an outpatient dialysis global budget (ODGB) through analysing the outpatient visits and medication received by those patients. METHODS:A sample of 4668 observations (patient year) of 13...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu119

    authors: Chang RE,Tsai YH,Myrtle RC

    更新日期:2015-11-01 00:00:00

  • Donor funding for health reform in Africa: is non-project assistance the right prescription?

    abstract::During the past 10 years, donors have recognized the need for major reforms to achieve sustainable development. Using non-project assistance they have attempted to leverage reforms by offering financing conditioned on the enactment of reform. The experience of USAID's health reform programmes in Niger and Nigeria sugg...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/9.4.371

    authors: Foltz AM

    更新日期:1994-12-01 00:00:00

  • Community-Based Interventions for Newborns in Ethiopia (COMBINE): Cost-effectiveness analysis.

    abstract::About 87 000 neonates die annually in Ethiopia, with slower progress than for child deaths and 85% of births are at home. As part of a multi-country, standardized economic evaluation, we examine the incremental benefit and costs of providing management of possible serious bacterial infection (PSBI) for newborns at hea...

    journal_title:Health policy and planning

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/heapol/czx054

    authors: Mathewos B,Owen H,Sitrin D,Cousens S,Degefie T,Wall S,Bekele A,Lawn JE,Daviaud E

    更新日期:2017-10-01 00:00:00

  • Patient satisfaction with task shifting of antiretroviral services in Ethiopia: implications for universal health coverage.

    abstract::Formalized task shifting structures have been used to rapidly scale up antiretroviral service delivery to underserved populations in several countries, and may be a promising mechanism for accomplishing universal health coverage. However, studies evaluating the quality of service delivery through task shifting have la...

    journal_title:Health policy and planning

    pub_type: 杂志文章

    doi:10.1093/heapol/czu072

    authors: Asfaw E,Dominis S,Palen JG,Wong W,Bekele A,Kebede A,Johns B

    更新日期:2014-09-01 00:00:00