Subject: WHO Barcelona: questions about Georgia Financial Protection analysis
From: Ketevan Goginashvili
To: GARCIA Jorge Alejandro <[email-masked]>
Cc: "[email-masked]<[email-masked]>" <[email-masked]>, [email-masked], "[email-masked]<[email-masked]>" <[email-masked]>, [email-masked], "[email-masked]<[email-masked]>" <[email-masked]>, [email-masked]
Date: Mon, 04 May 2020 13:12:32 +0000

Dear Jorge Alejandro,

1.In December 20 Mamuka sent revised tables to Jon (see attached file). Where data for 2017 is corrected.

2. data reported as absolute number in the appendix tables, are reported as annual values.

With best regards, Keti

From: Mamuka Nadareishvili [mailto:[email-masked]]
Sent: 04 May, 2020 15:09
To: Ketevan Goginashvili
Subject: Fwd: FW: Financial Protection for 2016-2018

---------- Forwarded message ---------
From: Mamuka Nadareishvili <[email-masked]>
Date: Fri, Dec 20, 2019 at 4:47 AM
Subject: Re: FW: Financial Protection for 2016-2018
To: Cylus,JD <[email-masked]>
Cc: THOMSON, Sarah <[email-masked]>, Ketevan Goginashvili <[email-masked]>

Dear Jon,

Thank you for the comments. Unfortunately, in tables 5 and 6 there were indeed errors caused by incorrect copying of numbers. I fixed these errors. The corrected part is given in red font. As for the numbers L43-45 and G43-46 in table 6, I recounted them and got the same results as in the table.

I am sending the corrected file.

wish you a merry Christmas and a Happy New Year.

Mamuka

On Thu, Dec 19, 2019 at 3:13 PM Ketevan Goginashvili <[email-masked]> wrote:

From: Cylus,JD [mailto:[email-masked]]
Sent: 19 December, 2019 14:51
To: Ketevan Goginashvili; THOMSON, Sarah
Subject: Re: Financial Protection for 2016-2018

Dear Keti,

I hope you are well! Apologies for being slow to review the results -- thanks for sending them.

They look mostly fine. Cata is quite high, as you know (17.4% by 2018, although that is slightly down from 2017), with the increase slightly driven by relatively poorer households (ie it is generally the impov and further impov which are increasing).  Inpatient care seems to have become more important as a driver in 2017 and 2018, at least when compared to 2016. Do these results seem sensible to you for those years?

On specifics:

Table 10 columns L and M did not match the shares in columns H and I.Good for Mamuka to have a look but I fixed in the attachment.

Table 6 G45 is 0 but should not be... actually L43-45 and G43-46 are weird.

Table 5 G32 to K42 is not correct... and the 2018 data for the EURO method on that table also don't sum completely, although that might be a rounding issue. actually i think that whole table has issues for 2017 and 2018.

These are of course fairly minor issues though.

Hope you have a nice Christmas and New Year.

best wishes,

Jon

From: Ketevan Goginashvili <[email-masked]>
Sent: 17 December 2019 14:20
To: THOMSON, Sarah <[email-masked]>
Cc: Cylus,JD <[email-masked]>
Subject: RE: Financial Protection for 2016-2018

Dear Sarah,

Thank you for information and support.

With best regards, Keti

From: THOMSON, Sarah [mailto:[email-masked]]
Sent: 17 December, 2019 18:01
To: Ketevan Goginashvili
Cc: Cylus,JD
Subject: RE: Financial Protection for 2016-2018

Dear Keti

Jon (copied) is just checking the numbers and as soon as that is done we will be able to pay you.

It will be very soon –

Thanks and best wishes

Sarah

From: Ketevan Goginashvili [mailto:[email-masked]]
Sent: Monday, 9 December 2019 06:08
To: THOMSON, Sarah <[email-masked]>
Subject: FW: Financial Protection for 2016-2018

Dear Sarah,

I hope you are doing well. I know you are very busy and of the year and I am sorry for bothering you. I am sending Mamuka’s and my work previous week. I hope, you received it. I know you have a lot of question regarding the data and report. We will finalizing it after your comments. Is it possible to reimburse Mamuka’s and My second installment of the first contract (1500$) and second contract (500$). I am asking you because it is end of the year.

Thank you in advance,

With best regards,

Keti

From: Ketevan Goginashvili
Sent: 02 December, 2019 10:55
To: 'THOMSON, Sarah'
Cc: 'Cylus,JD'; Mamuka Nadareishvili
Subject: Financial Protection for 2016-2018

Dear Sarah,

I hope you are doing well. I am sending tables and updated report for 2010-2018. Thank you for support.

With best regards, Keti

From: THOMSON, Sarah [mailto:[email-masked]]
Sent: 06 November, 2019 20:53
To: Ketevan Goginashvili; Mamuka Nadareishvili
Subject: RE: Financial Protection for 2016-2017

Dear Keti and Mamuka

This is great, thanks. I attach the terms of reference for you both – please check them and confirm if they are OK.

Many thanks

Sarah

From: Ketevan Goginashvili [mailto:[email-masked]]
Sent: Wednesday, 6 November 2019 13:39
To: THOMSON, Sarah <[email-masked]>
Cc: Mamuka Nadareishvili <[email-masked]>
Subject: RE: Financial Protection for 2016-2017

Dear Sarah,

Thank you for support. Mamuka and me are ready to analyses the data 2018.

We will start analysis process as soon as possible.

With best regards, Keti

From: THOMSON, Sarah [mailto:[email-masked]]
Sent: 06 November, 2019 15:49
To: Ketevan Goginashvili
Subject: RE: Financial Protection for 2016-2017

Dear Keti

Would you do the analysis with Mamuka again? If yes, we can offer you a fee of USD 500 each to prepare the numbers for 2018 and add them to the existing appendix tables. How soon can you do the analysis?

If you let me know, I will prepare the terms of reference.

Once we have the numbers, Erica will add them to the draft report.

I hope all is well at your end!

Thanks and best wishes

Sarah

From: THOMSON, Sarah
Sent: Wednesday, 6 November 2019 12:45
To: Ketevan Goginashvili <[email-masked]>; Cylus,JD <[email-masked]>
Subject: RE: Financial Protection for 2016-2017

Dear Keti

I discussed this briefly with Silviu and we think it would be useful to have the 2018 data, so it would be good to proceed so long as it can be done relatively quickly.

I will write to you separately about a contract.

Thanks and best wishes

Sarah

From: Ketevan Goginashvili [mailto:[email-masked]]
Sent: Friday, 25 October 2019 03:27
To: THOMSON, Sarah <[email-masked]>; [email-masked]
Subject: Re: Financial Protection for 2016-2017

Dear Sarah,

Thank you for support and possibility to evaluate of country’s financial protection. As you are informed in May 2017, new criteria for differentiation of beneficiaries (according to beneficiaries' revenue) has been implemented (also 500 and 1000GEL deductible). Geostat already has Household budget survey data for 2018. It will be very interesting to see how influence this changes on financial protection of population. If you are interested and if is possibility to support us conduct financial protection evaluation for 2018.  New minister is sinking new wave of reforms and review of the current situation will be important.

Thank you again,

With best regards, Keti

From: Sarah THOMSON <[email-masked]>
Date: Thursday, October 10, 2019 at 00:48
To: Ketevan Goginashvili <[email-masked]>, "[email-masked]" <[email-masked]>
Cc: Erica Richardson <[email-masked]>
Subject: RE: Financial Protection for 2016-2017

Dear Keti

Thank you for this. I am pleased to let you know that Erica (copied) is now editing the Georgia report. We expect to finalise the report in the next few weeks. We will then share it with Triin and Silviu for their feedback, before we share it with the Minister.

We will of course send it to you first, with any outstanding queries.

I hope that sounds OK to you and Mamuka.

Best wishes

Sarah

From: Ketevan Goginashvili [mailto:[email-masked]]
Sent: Wednesday, 9 October 2019 15:28
To: THOMSON, Sarah <[email-masked]>; [email-masked]
Subject: FW: Financial Protection for 2016-2017

Dear Sarah,

In September I sent draft report and excel files.

Please, if you have time see it and send us comments.

With best regards,

Keti

Ketevan Goginashvili, MPH

Head of Health Policy Division

Health Care Department

Ministry of Internally displaced Persons

from  Occupied Territories,

Labor, Health and Social Affairs

144 Tsereteli Ave

Tbilisi 0119, Georgia

Tel: +995 32 251 00 38 ext 1108

Mob: 995 577717984

From: Ketevan Goginashvili
Sent: 19 September, 2019 05:23
To: THOMSON, Sarah; Cylus,JD
Cc: Mamuka Nadareishvili
Subject: Re: Financial Protection for 2016-2017

Dear Sarah,

I hope you are doing well. Thank you for your comments and I am sorry for late reply.

·         Catastrophic incidence really increases a lot by 2017. Is there any obvious reason for this? – Changes in May, 2017 – stratification services by income groups is influenced oop and catastrophic incidence.

·         There is a weird shift in catastrophic OOPs by structure in 2016 where inpatient falls and outpatient increases... but then in 2017 the inpatient share returns to something close to what it was in 2015 and before. We should ask them to double check that the categories have been defined correctly (for example, in 2015 24% of catastrophic OOPs was inpatient, then in 2016 it was 16.5% and then it was back up to 27.8% by 2017) but perhaps this also linked to the reforms (I can't remember all the details now). Does this shift make sense? Only one explanation: In 2016 number of visits in PHC facilities per person was maximum – 3.9, and one of the reasons is the introduction of an electronic prescription and the mandatory requirement for Tbilisi medical institutions to participate in a universal health program.

·         Columns N to R of column 10 are missing (also J to M was calculated in a different way but I fixed it... see the attached file). Mamuca changed it (see attached table)

·         Column 3 row T of table 13 seems too low... perhaps it was copy pasted wrong? I think it should be 10.6% (see B2 of table 10) but good to double check. Mamuca changed it (see attached table)

Thank you again to give us possibility see our reform results in numbers…

With best regards, Keti

From: Sarah THOMSON <[email-masked]>
Date: Thursday, August 29, 2019 at 18:52
To: Ketevan Goginashvili <[email-masked]>, "Cylus,JD" <[email-masked]>
Subject: RE: Financial Protection for 2016-2017

Dear Keti

Thank you very much for your email and work on the FP analysis for 2016 and 2017. Sorry I was slow to respond – I was on leave when your email came and since being back in the office I have been dealing with the back log.

I hope all is well and you are adjusting to life with a new minister!

Jon has had a look at the results and his comments are:

·         Catastrophic incidence really increases a lot by 2017. Is there any obvious reason for this?

·         There is a weird shift in catastrophic OOPs by structure in 2016 where inpatient falls and outpatient increases... but then in 2017 the inpatient share returns to something close to what it was in 2015 and before. We should ask them to double check that the categories have been defined correctly (for example, in 2015 24% of catastrophic OOPs was inpatient, then in 2016 it was 16.5% and then it was back up to 27.8% by 2017) but perhaps this also linked to the reforms (I can't remember all the details now). Does this shift make sense?

·         Columns N to R of column 10 are missing (also J to M was calculated in a different way but I fixed it... see the attached file).

·         Column 3 row T of table 13 seems too low... perhaps it was copy pasted wrong? I think it should be 10.6% (see B2 of table 10) but good to double check.

Please have a look and let us know what you think –

With thanks and best wishes

Sarah

From: Ketevan Goginashvili [mailto:[email-masked]]
Sent: Tuesday, 30 July 2019 09:00
To: THOMSON, Sarah <[email-masked]>
Cc: Cylus,JD <[email-masked]>
Subject: Financial Protection for 2016-2017

Dear Sarah,

I hope you are doing well.

I am sending excel files for Financial Protection - 2016-2017.

Final draft report I will send after two weeks.

With best regards, Keti

Ketevan Goginashvili, MPH

Head of Health Policy Division

Health Care Department

Ministry of Internally displaced Persons

from  Occupied Territories,

Labor, Health and Social Affairs

144 Tsereteli Ave

Tbilisi 0119, Georgia

Tel: +995 32 251 00 38 ext 1108

Mob: 995 577717984