全民医疗保障中的公平:残疾人是否同样受益?
Szu-Han Chen1, Meng Jie Hsu2, Christy Pu1,2
1Department of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taiwan.
概括
台湾的残疾人更容易获得国家医疗保险 (NHI) 的医疗服务和净福利. 然而,较高的共同支付可能会抵消这些收益,而财务保护因收入而异.
科学领域:
- 健康经济学
- 公共卫生政策
- 关于残疾人的研究
背景情况:
- 全球卫生覆盖范围正在扩大.
- 台湾国家医疗保险 (NHI) 旨在提供全面的医疗保险.
- 根据UHC对残疾人的经济保护仍未得到充分研究.
研究的目的:
- 分析台湾NHI对残疾人的净经济效益.
- 为了比较NHI对残疾人和非残疾人的净收益.
- 确定影响残疾人的净收益的因素.
主要方法:
- 使用台湾国家残疾人登记处和NHI索赔数据 (2014-2021年).
- 将933,304名残疾人与没有残疾的对照人进行匹配 (1:1比率).
- 定义净福利是医疗护理价值减去个人费用 (保险费和共同支付);采用了两部分模型.
主要成果:
- 在所有服务类型中,残疾人使用和支出显著增加 (P < 0.001).
- 净福利与残疾严重程度相比增加,从62,189 NTD (轻度) 到461,346 NTD (非常严重),而无残疾人则为19,969 NTD.
- 尽管福利较高,但残疾人面临更高的共同支付,收入影响了净福利结果.
结论:
- 台湾的NHI为残疾人提供了一定的经济保障.
- 对于残疾人来说,高额的共同支付可能是一个障碍.
- 根据各个社会经济群体, 国民健康保险的再分配影响有所不同,
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