Organisational framework and outputs of International medical evacuation in Guinea: A need for change

• Published in: The International journal of health planning and management 2018-07, Vol.33 (3), p.614-626
• Main Authors: Guilavogui, Timothé, Camara, Alioune, Diallo, Elhadj Marouf, Koïvogui, Akoï, Barry, Aminatou, Zoumanigui, Koligna, Diallo, Alpha Ahmadou, Delamou, Alexandre, Koulibaly, Moussa
• Format: Article
• Language: English
• Subjects: Budgets; Cardiovascular diseases; cost of health evacuations; Diagnostic systems; Evacuation; Exploration; free health treatment; Health services; health system; Heart diseases; International Medical Evacuation; Medical treatment; Motivation; Neurosurgery; Occupational health; Prospects; Social security; Socialist societies; Strength; Structural failure; Sustainability
• ISSN: 0749-6753; 1099-1751
• DOI: 10.1002/hpm.2507

Summary The study aims to describe the organizational framework of International Medical Evacuation (IME), the profile of persons evacuated, and the associated cost of IME in Guinea. This was a descriptive study of IME policy in Guinea. We described the politico‐structural organization of IME and the profile of patient accessing IME through the Ministry of Health (MOH: 2001–2015) and through the National Social Security Fund (NSSF: 2011–2015). From 1958 to 1992 since the health system was restricted, the country negotiated the free medical treatment with Socialist countries. Since 1992, a medical assistance line was included in the sector budgets, and IME was officially managed by the MOH and with a parallel system existing at the NSSF. With an average cost of US $34 251 per case, cardiovascular diseases (20%), Traumatology/Orthopedic diseases (20%), and Neurologic/neurosurgery diseases (12.5%) have motivated more than half of 2445 IME supported by the MOH between 2001 and 2015. With a diagnostic exploration (38.7%) as main motivation, the majority of the IMEs (80.0%) endorsed by the NSSF (2011–2015) concerned their employees/workers or those of the NSSF's supervisory ministry and their families. Despite a strict regulatory framework, the emergence and sustainability of parallel IME systems in other departments with different procedures than MOH's procedure represent a major weakness/deficiency. The new prospects for the free medical treatment of state employees could eventually lead to an effective correction of this structural failure if efficiently managed.