By Ricardo A. Bitran

ISBN-10: 0821323423

ISBN-13: 9780821323427

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I thank Frank Baer, Manunga Mapele, Steven Brewster, and Munkatu Mpese, from SANRU, for their helpful ideas and suggestions. The field data used to develop the model were collected in Zaire from the health zones of Kisantu, in Lower Zaire, and Bokoro in the Bandundu Region. I am grateful to Dr. Kamba, from Kisantu, and Dr. Yves Heyligers, from Bokoro, for their enthusiastic collaboration. Helpful ideas were provided by Elca Rosenberg, Margaret Saunders, Mead Over, Jacques Baudouy, Ed Elmendorf, and Jean Louis Lamboray from the World Bank; by Drs.

4 Preventive Care The demand for preventive care services is similarly specified, except that the relevant population groups are either children under five (for preschool care) or pregnant women (for prenatal care) instead of people with a health problem. Consumer Categories Three categories of consumers are included in the model: the uninsured people who pay the providers' full price; the people who are insured at the health center through the payment of an annual insurance premium and who pay a copayment (that is, a proportion of the full health center price) when obtaining care at the health center; and the uninsured people who are given free care at the health center, referred to as the nonpaying.

Once Q is known the model calculates the focus health facility's total revenue (TR) by multiplying demand (Q) times price (P). At the same time, demand, which is equal to the amount of services produced by the facility, determines the facility's total cost (TC). As shown in the figure, however, cost not only depends on Q, but is also a function of other factors such as the exchange rate (FX), which directly affects the costs of drugs and fuel; the cost of labor (L); and other variables. The difference between total revenue and total cost is the facility's net income (NI), or profit.

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A supply-demand model of health care financing with an application to Zaire: a training tool by Ricardo A. Bitran


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