全民健康覆盖的地区级监测,印度
Arnab Mukherji1, Megha Rao2, Sapna Desai3
1Centre for Public Policy, Indian Institute of Management, IIM Bangalore, Bengaluru, Karnataka560076, India.
Bulletin of the World Health Organization
|September 2, 2024
概括
一个新的框架在印度的地区层面测量了全民健康覆盖 (UHC),揭示了显著的地理差异和基于财富的不平等. 该工具有助于确定需要有针对性的卫生干预措施的领域.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 全民健康覆盖 (UHC) 是全球优先事项,但在次国家层面衡量进展,特别是在印度等多样化的环境中,仍然具有挑战性.
- 现有的框架往往缺乏细节性,无法为当地卫生系统的规划和资源分配提供信息.
研究的目的:
- 开发和验证一个地区级的框架和指数来衡量印度的全民健康覆盖 (UHC).
- 评估印度各个地区对UHC的现状和进展情况.
主要方法:
- 调整了世卫组织/世界银行框架,以创建一个地区级的UHC指数,使用从687个印度地区定期收集的健康数据.
- 根据五个领域的24个追踪指标计算了指数:RMNCH,传染病,非传染性疾病,服务能力/访问和金融风险保护.
- 通过14个财富,城乡,宗教和社会群体维度的指标,分析了区内不平等.
主要成果:
- 地区级UHC指数的中位数为43.9% (范围:26.4-69.4%),具有显著的地理差异,特别是印度南部州的得分更高.
- 在大多数指标上,服务覆盖率超过了60%,除非传染性疾病和服务能力/访问.
- 观察到医疗保险覆盖范围有限,约有10%的人口经历了灾难性的或致贫的医疗支出,以及基于财富的显著差异.
结论:
- 在印度,UHC可以有效地在地区层面进行测量,为当地卫生系统的表现提供有价值的见解.
- 开发的UHC指数和不平等评估可以指导国家和地方政府优先考虑干预措施,并确定具有有限UHC进展的地理"热点".
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