تمويل التامين محمد الصحي ودوره في تقويم الخدمة الطبيية للمؤمنين عليهم (دراسة محاسبية ميدانية)

Abstract

J Abstract The study dealt with health insurance funding and its role in providing health service to the insured. The problem of the study lies in the inflation of the cost of medical services. The importance of the study emanates from the big role played by health insurance through offering medical and therapeutic services at the lowest cost possible and affordable by poor people where health insurance system in Sudan is based on solidarity between health insurance (HI) and members of the community. Health insurance in Sudan targets the poor and the vulnerable groups. The study aimed at finding permanent financial resources through investment to guarantee continuity and expansion of service and minimize the dependence of health insurance resources only on the contribution of the employers, subscribers and the other funds. To verify the problem of the study and realize its objectives the researcher conducted a field study on some accounts employees and insurance officers in addition to a number of university lecturers in Khartoum City and tested the following hypotheses: l. There statistically significant relationship between the financing of health insurance and medical service provided by the health insurance for the insured. 2. The services provided by health insurance assist in alleviating the economic burden layed the shoulders ofthe insured. 3. Strive to functionalize health insurance act to enable diversification of health financing resources lead to increasing the financial resources of the National Health Insurance Fund. The researcher came out with several results including: 1. Attract miscellaneous groups to enter in the service of health insurance contributes to the development of health insurance resources. 2 The quality of the medical service provided to the insured motivates the limited income groups to enter under the umbrella of health insurance.

J Regular payment of subscriptions help in increasing the resources of health insurance fund and lead to improvement of the medical services offered to the insured. Entering the private sector groups (banks — companies) under the umbrella of health insurance contributes to increasing the resources of health insurance and provision of quality services. The researcher set forth a number of recommendations including: The necessity of increasing the entry of social support groups through the government under the aegis of health insurance. This will lead to increasing the resources of health insurance and excellence of thc service. The importance of financing health insurance through the proceeds of investing its funds to ensure medical and laboratory diagnosis to the insured. The management of the National Health Insurance Fund should strive hardly to functionalize the regulations with the purpose of increasing the resourcesof health insurance. The management of the national health insurance fund should endeavour to increase the resources of health insurance by soliciting support through donors and gifts.