家庭寻求健康的行为和对非正式支付的反应:经济地位是否重要?
Chukwudi Nwokolo1,2,3, Obinna Onwujekwe4,5, Martin McKee6
1Department of Economics, University of Nigeria, Nsukka, Nigeria. chukwudi.nwokolo@unn.edu.ng.
Health economics review
|October 16, 2025
概括
尼日利亚医疗保健机构的非正式支付不成比例地影响较贫穷的家庭,导致他们寻求质量较差的护理. 解决这种腐败问题对于公平获得高质量的医疗服务和减少经济负担至关重要.
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:
- 腐败显著影响寻求健康的行为,但在正式医疗保健环境中对其在不同人口群体的影响的经验证据有限.
- 尼日利亚研究了非正式支付,这是医疗保健中普遍存在的腐败形式.
- 家庭的经济地位在维持这些非正式的支付实践方面发挥着作用.
研究的目的:
- 调查非正式支付对尼日利亚寻求健康行为的影响.
- 分析家庭经济状况如何影响和维持医疗保健系统内的非正式支付.
- 提供有关腐败对寻求医疗服务的各种社会经济群体的影响差异的证据.
主要方法:
- 在尼日利亚埃努古州和卡诺州的1652个家庭中,使用预先测试的面试官管理的问卷进行了一项研究.
- 描述性统计数据被用来分析家庭寻求健康的行为.
- 常规最小平方,二进制物流和多项物流回归分析被用来评估非正式支付和经济地位 (五分位数) 对寻求健康行为的影响.
主要成果:
- 较贫穷的家庭主要使用卫生站和中心,而极富的家庭不成比例地使用医院 (59%).
- 富裕家庭更有可能进行非正式支付 (p < 0.05),家庭规模,患者年龄,性别,教育程度和国家也影响了这些支付.
- 在公共设施中非正式支付的经验显著减少了使用第三级医院的58% (p < 0.05) 和选择第三级医院而不是初级保健的31% (p < 0.01).
结论:
- 在公共医疗机构的非正式支付对寻求健康的行为产生了负面影响.
- 这些做法迫使最贫穷的家庭转向质量较差的护理服务.
- 解决非正式支付问题对于降低医疗保健的经济负担和实现尼日利亚获得高质量服务的平等机会至关重要.
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