对于土著居民来说,不公平的健康金融保护:墨西哥案例
Edson Serván-Mori1, Sergio Meneses-Navarro2,3, Rocio Garcia-Diaz4
1Center for Health Systems Research, The National Institute of Public Health, Cuernavaca, Mexico.
Journal of racial and ethnic health disparities
|September 11, 2023
概括
墨西哥土著家庭的金融保护显示了持续的不平等. 灾难性卫生支出 (CHE) 减少,但随后趋同,而贫困性 (IHE) 和过度 (EHE) 的卫生支出增加,突出了针对性干预的需要.
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
- 社会经济上的不平等.
背景情况:
- 在低收入和中等收入国家的土著 (IH) 和非土著 (NIH) 家庭的金融保护方面的理解存在重大差距.
- 专注于评估墨西哥的灾难性 (CHE),贫穷 (IHE) 和过度 (EHE) 的医疗支出.
研究的目的:
- 评估2008-2020年墨西哥IH和NIH中CHE,IHE和EHE的水平,社会经济不平等以及趋势.
- 确定土著和非土著人口之间的金融保护差异.
主要方法:
- 全国家庭收入和支出调查数据的综合横截面分析 (n=315,829).
- 根据土著地位分层的Wagstaff度指数来评估社会经济不平等.
- 使用最大概率的两阶段探针模型进行调整分析.
主要成果:
- CHE,IHE和EHE集中在最贫穷的土著家庭中.
- CHE最初下降,但到2020年趋同; IHE在2014年后大幅增加 (40%),EHE在2014年出现下降,然后上升并稳定在更高的水平.
- 在整个研究期间,在医疗支出保护方面存在种族差距.
结论:
- 有效的金融保护机制对于实现全民健康覆盖至关重要.
- 解决结构性不平等和歧视,特别是种族化问题,对于土著人民来说至关重要.
- 实施有针对性的政策可以帮助缩小在健康成果和财务保护方面持续存在的种族差距.
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