English   Français   Espanol

Agregar un término

a b c d e f g h i j k l m

n o p q r s t u v w x y z

   Refers to the level of health expenses – incurred in connection with the utilization of a given health service – for which the scheme agrees to assume responsibility. The level of coverage may be expressed as a percentage of the health expenses actually incurred (for example, 65 per cent of expenses incurred for medical tests) or as a maximum amount or number of utilizations (for example, coverage of consultations up to a maximum limit of 1,000 Monetary Units (MUs) for each consultation). It may also combine the two terms (for example, coverage of 80 per cent of expenses, up to a maximum of four consultations per person and per year). [ILO-STEP, 144]

   All health infrastructures that share the same functions. Dispensaries, health posts, health centres and doctors' offices generally constitute the first level; provincial or area hospitals make up the second level; and regional or university hospitals account for the third level. A compulsory referral system often exists for transfers from one level of the pyramid to the next, but is not applied in the case of emergencies. [ILO-STEP, 144]
See: health pyramid, compulsory referral
Synonym: level of the health pyramid

   Linkages refer to all types of partnership agreements between institutions, which aim to facilitate the access, management or financing of social security.
Institutions involved may include:

• Other micro-insurance system(s);
• Civil society organizations (local NGO, associations, etc.);
• Micro-finance institutions;
• Associations or federations of mutual health organizations;
• Networks of cooperatives, trade unions;
• Outsourced technical management providers such as Indian TPAs, public management centres, accounting experts;
• Pharmaceutical industry or other industries;
• Private or public insurance companies;
• Social security funds;
• Social assistance programmes;
• Public health and prevention programs;
• Local or national governments;
• International cooperation (International NGO, United Nations, global social trust, global fund)

• Subsidies and redistribution;
• Financial consolidation (reinsurance, guarantee funds);
• Technical support and advice;
• Pooled management functions;
• Support in enrolment and premium collection;
• Information sharing and best practices;
• Regulation and/or control;
• Joint contractual agreements with healthcare providers or defining and establishing a contractual agreement framework;
• Access to networks of healthcare providers;
• Joint participation in defining and establishing national strategies for extending social protection (linkages at a political level)

   Types of benefit that are aimed at replacing earned income in the case of more or less permanent loss of earnings resulting from old age, disability or the death of the breadwinner (survivor benefits). [ILO,694]
See also: short-term benefits

   The difference between income and expenditure for a given accounting period, where expenditure exceeds income. Depending upon legislation and the legal status of the organization, other terms, such as "deficit", may be used. [ILO-STEP, 144]

   One-time capital payments to members of a scheme designed to provide only capital sums upon the retirement, invalidity or death of a protected person (i.e provident funds). [ILO,694]