一个尺寸不适合所有人:灾难性医疗支出的收入敏感门
Jay Dev Dubey1, Dushyant Kumar1, Bheemeshwar Reddy A1
1Department of Economics & Finance, Birla Institute of Technology & Science (BITS), Pilani Hyderabad Campus.
Health policy and planning
|February 6, 2026
概括
这项研究引入了反向排名加权指数 (IRWI),以更好地评估灾难性卫生支出 (CHE). 新方法提供了更公平,收入敏感的门,揭示了更多家庭因医疗费用而面临经济困难.
科学领域:
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
- 计量经济学 计量经济学
背景情况:
- 灾难性医疗支出 (CHE) 是全球家庭的重大财务负担.
- 现有的确定CHE门的方法,如统一或比例的方法,可能不准确地反映家庭收入水平和支出模式.
- 需要特定组件的门来更好地了解不同类别的自费支出 (OOPE) 的财务影响.
研究的目的:
- 开发和验证一个反向等级加权指数 (IRWI),用于调整自费支出 (OOPE) 组件的灾难性门.
- 使用印度家庭调查数据,比较CHE估计的统一,比例和IRWI值.
- 建立一个更公平,更准确的框架来评估由于医疗保健支出造成的财政困难.
主要方法:
- 开发反向等级加权指数 (IRWI) 来衡量OOPE组件的有效支出份额.
- 对印度 (2017-18年) 医疗保健消费的全国代表性家庭调查数据的分析.
- 估计和比较灾难性医疗支出 (CHE) 发生率,使用统一,比例和IRWI值在总和组件层面.
主要成果:
- 统一的值大大低估了CHE的发生率.
- 特定组件的门值,特别是来自IRWI的门值,与统一的门值相比,识别出经历CHE的家庭数量是其两倍.
- 从比例到IRWI值的转变大大改变了CHE的估计,突出了收入敏感性的影响.
结论:
- IRWI方法提供了一种更可靠和公平的方法来评估CHE,通过结合特定收入的支出模式.
- 特定组件,收入敏感的门对于准确量化财务困难和避免低估医疗保健经济负担至关重要.
- 这些发现倡导采用IRWI框架,以便更精确地制定与医疗保健融资和财务保护有关的政策.
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