医療保険の公平性: 障害者が平等に恩恵を受けるのか
Szu-Han Chen1, Meng Jie Hsu2, Christy Pu1,2
1Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taiwan.
まとめ
台湾の障害者は,国民健康保険 (NHI) による医療利用と純利益の増加を経験しています. しかし,高額な付加金はこれらの利益を相殺し,金銭的保護は収入によって異なります.
科学分野:
- 健康 経済
- 公衆衛生政策
- 障害者に関する研究
背景:
- ユニバーサルヘルスケア (UHC) は 世界的に拡大しています
- 台湾の国民健康保険 (NHI) は,包括的な保険を提供することを目的としています.
- UHCの下での障害者の経済的保護は,まだ十分に研究されていない.
研究 の 目的:
- 台湾のNHIが障害者に与える 純利益を分析する.
- NHIの障害者と非障害者の純利益を比較する
- 障害者の純利益に影響を与える要因を特定する.
主な方法:
- 台湾の全国障害者登録とNHIの請求データ (2014-2021) を利用した.
- 障害のある93万3,304人を,障害のない対照群に合わせた (1:1比).
- 医療費の額から個別費用 (保険料と付加金) を引いた純利益; 2つの部分のモデルを採用した.
主要な成果:
- 障害のある人は,すべてのサービスの利用と支出が著しく高かった (P < 0.001).
- 障害の重度に応じて,純給付は増加し,障害のない人の場合は19,969 NTDに比べて62,189 NTD (軽度) から461,346 NTD (非常に重度) に達した.
- 高額な給付にもかかわらず,障害者はより大きな共同支払いに直面し,収入は純給付結果に影響しました.
結論:
- 台湾のNHIは 障がいを持つ人々に 経済的保護を提供しています
- 高額な共同支払いは,障害のある人にとって障害となる可能性があります.
- NHIの再分配効果は社会経済的グループによって異なり,潜在的な不平等を強調しています.
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