政府补贴计划对卫生融资公平性的影响
Yousef Mohammadzadeh1, Aysan Sheikhmali2, Jafar Yahyavi Dizaj3
1Department of Economics, Faculty of Economics and Management, Urmia University, Urmia, Iran. yo.mohammadzadeh@urmia.ac.ir.
Cost effectiveness and resource allocation : C/E
|August 14, 2023
概括
伊朗政府的补贴计划,即有针对性的补贴计划 (TSP) 和卫生转型计划 (HTP),并没有显著改善卫生融资公平性或减少灾难性的卫生支出. 建议针对弱势家庭提供有针对性的支持,并改善保险.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
- 健康的社会决定因素
背景情况:
- 伊朗于2010年实施了有针对性的补贴计划 (TSP),以减少能源消耗和不平等.
- 卫生部推出了健康转型计划 (HTP),以减少自付医疗费用.
- 这两项政策都旨在提高卫生融资的公平性.
研究的目的:
- 评估TSP和HTP对伊朗卫生融资公平性的影响.
- 分析金融贡献公平性指数 (FFC) 和灾难性医疗支出 (CHE) 的变化.
主要方法:
- 利用了来自528,046个家庭的14年 (2007-2020年) 的家庭调查数据.
- 计算了财务贡献公平性指数 (FFC) 和灾难性医疗支出指数 (CHE).
- 在 Stata V.14 中使用物流回归分析来评估 CHE 的政策影响和社会经济决定因素.
主要成果:
- FFC指数显示的变化很小,从2007年的0.829到2020年的0.795.
- 无论是TSP还是HTP,都没有显著减少家庭对CHE的暴露.
- 弱势家庭 (老年人,低收入,农村,贫困地区,拥挤,缺乏住房) 面临更高的CHE风险.
- 医疗保险覆盖范围没有缓解CHE;高等教育和就业与较低的CHE相关.
结论:
- 政府补贴计划 (TSP,HTP) 在改善FFC和减少CHE方面无效.
- 到第六个国家发展计划时,将CHE降至1%的目标没有实现.
- 针对弱势家庭的有针对性的支持方案至关重要.
- 强烈建议改善医疗保险覆盖的质量和有效性.
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