1. PHC & Business: at whose Cost?
Koustuv Dalal, PhD
Director, Centre for Injury Prevention and Safety Pomotion,-
A WHO CCCSP Strategic Centre
Örebro University, SWEDEN

2. Health as economic goods
Demand for health consists of two simultaneous choices:
(1) Consumption:
health yields direct utility (satisfaction) i.e. you feel better when you are healthier
(2) Investment:
health increases the number of days available to participate in market and non-market activities – the novel bit of the model
Total Time = 365 days = T H (Improving Health)
+ TB (Producing Home goods)
+ TL (Loss for illness)
+ TW (Work)
Leisure

3. Investing in health INPUTS Health Care OUTPUT P R P Diet O R HEALTH
D O
U C
C E
T S
I S O N
Diet
HEALTH
STOCK
HEALTHY DAYS
Physical
Mental
Limited activity
Exercise
Environment
Income
Time

4. Society Economic Burden Children Older Peoples Productive age
40-45
Older Peoples
Life
years
Productive age 20
> 20
Society
Unhealthy
Peoples
Economic Burden
Elderly

5. Major Healthcare Financing Models
Revenue Source
Groups Covered
Care Provision
Finance
National Health Service
General revenues
Every one
Public providers
Central government
Social Health Insurance
Taxes from payroll
Specific groups
Own, public, or private facilities
Semi-autonomous organizations
Community-based Health Insurance
Private, voluntary contributions
Contributing
members
NGOs or private facilities
Non-profit plans
Voluntary Health Insurance
Private voluntary contributions
Contributing members
Private and public facilities
For- profit and non-profit insurance organizations
Out-of-Pocket Payments (including public user fees)
Individual payments to providers
Public and private facilities (public facilities)
KEEP.

6. Experience from SWEDEN after privatization of management (service paid by public money)
Shortage of physicians
High mobility of physicians
Over phone screening by nurses
Delay-dealing
Long waiting time
=> Most importantly over-use of over-the-counter drugs (paracetamol, pain-killers, vitamins etc)

7. Kazakhstan economy is in transition Population health is very important for steady economic growth. Business in healthcare has detrimental effects of population health (inequality) Do you think my Kazakh sisters and brothers are ready to accept such healthcare challenges?

8. Спасибо