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The impact of vouchers on the use and quality of health care in developing countries: A systematic review

机译：代金券对发展中国家医疗保健的使用和质量的影响：系统评价

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One approach to delivering healthcare in developing countries is through voucher programmes, where vouchers are distributed to a targeted population for free or subsidised health care. Using inclusion/exclusion criteria, a search of databases, key journals and websites review was conducted in October 2010. A narrative synthesis approach was taken to summarise and analyse five outcome categories: targeting, utilisation, cost efficiency, quality and health outcomes. Sub-group and sensitivity analyses were also performed. A total of 24 studies evaluating 16 health voucher programmes were identified. The findings from 64 outcome variables indicates: modest evidence that vouchers effectively target specific populations; insufficient evidence to determine whether vouchers deliver healthcare efficiently; robust evidence that vouchers increase utilisation; modest evidence that vouchers improve quality; no evidence that vouchers have an impact on health outcomes; however, this last conclusion was found to be unstable in a sensitivity analysis. The results in the areas of targeting, utilisation and quality indicate that vouchers have a positive effect on health service delivery. The subsequent link that they improve health was found to be unstable from the data analysed; another finding of a positive effect would result in robust evidence. Vouchers are still new and the number of published studies is limiting.
机译：在发展中国家提供医疗保健的一种方法是通过代金券计划，将代金券分发给目标人群，以获得免费或有补贴的医疗保健。使用纳入/排除标准，于2010年10月对数据库，主要期刊和网站进行了搜索。采用叙事综合方法来总结和分析五个结果类别：目标，利用，成本效率，质量和健康结果。还进行了亚组和敏感性分析。共确定了24个评估16个健康券计划的研究。来自64个结果变量的结果表明：凭证有效针对特定人群的适度证据；没有足够的证据来确定凭单是否可以有效地提供医疗保健；有力的证据表明凭证可以提高利用率；凭证有效改善的适度证据；没有证据表明凭单会影响健康结果；但是，在敏感性分析中发现最后一个结论是不稳定的。目标，利用和质量方面的结果表明，代金券对卫生服务的提供有积极作用。从分析的数据来看，他们随后改善健康的联系不稳定。另一个积极影响的发现将产生有力的证据。代金券仍然是新的，已发表的研究数量有限。

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