Household catastrophic health expenditure: evidence from Georgia and its policy implications.
Household catastrophic health expenditure: evidence from Georgia and its policy implications.
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DOI：
10.1186/1472-6963-9-69
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发表时间：
2009-04-28
影响因子：
2.8
通讯作者：
Rukhadze N
中科院分区：
文献类型：
--
作者：
Gotsadze G;Zoidze A;Rukhadze N
量化灾难性家庭保健支出的程度，确定影响它的因素，并估计格鲁吉亚的公平筹资指数，以确定预期改革的基线，并有助于设计和微调政府在2007年年中启动的保健筹资方面的重大改革。这项研究基于2007年5月至6月期间进行的具有全国代表性的保健利用和支出调查，该调查是在为实施保健筹资改革的新阶段做准备之前进行的。根据WHO-KE Xu提出的方法估算了家庭的灾难性卫生费用。采用Logistic回归(LOGIT)模型预测巨灾医疗费用发生的概率。在格鲁吉亚，2000年至2007年期间，穷人获得护理的机会略有改善，面临灾难性医疗支出的家庭所占比例似乎从1999年的2.8%增加到2007年的11.7%。然而，这种差异可能与分析所依据的各个调查的方法不同有关。灾难性卫生支出的高水平可能与国民卫生支出中预付比例低、服务提供充足以及该国贫困程度高有关。决定与健康不良相关的金融灾难的主要因素是住院、患有慢性病的家庭成员和家庭的贫困状况。自2004年以来，格鲁吉亚的FFC似乎有所改善。减少灾难性卫生支出的流行是政府的一项政策目标，可以通过以下方式实现这一目标：侧重于增加对穷人的财政保护，并通过纳入和扩大住院覆盖范围以及增加药品福利来扩大对穷人和慢性病患者的政府资助福利。这一政策建议可能也适用于具有类似自付水平和灾难性卫生支出水平的其他低收入和中等收入国家。
To quantify extent of catastrophic household health expenditures, determine factors influencing it and estimate Fairness in Financial Contribution (FFC) index in Georgia to establish the baseline for expected reforms and contribute to the design and fine-tuning of the major reforms in health care financing initiated by the government mid-2007. The research is based on the nationally representative Health Care Utilization and Expenditure survey conducted during May-June 2007, prior to preparing for new phase of implementation for the health care financing reforms. Households' catastrophic health expenditures were estimated according to the methodology proposed by WHO – Ke Xu. A logistic regression (logit) model was used to predict probability of catastrophic health expenditure occurrence. In Georgia between 2000 and 2007 access to care for poor has improved slightly and the share of households facing catastrophic health expenditures have seemingly increased from 2.8% in 1999 to 11.7% in 2007. However, this variance may be associated with the methodological differences of the respective surveys from which the analysis were derived. The high level of the catastrophic health expenditure may be associated with the low share of prepayment in national health expenditure, adequate availability of services and a high level of poverty in the country. Major factors determining the financial catastrophe related to ill health were hospitalization, household members with chronic illness and poverty status of the household. The FFC for Georgia appears to have improved since 2004. Reducing the prevalence of catastrophic health expenditure is a policy objective of the government, which can be achieved by focusing on increased financial protection offered to poor and expanding government financed benefits for poor and chronically ill by including and expanding inpatient coverage and adding drug benefits. This policy recommendation may also be relevant for other Low and Middle Income countries with similar levels of out of pocket payments and catastrophic health expenditures.
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影响因子：
2.1
作者：
Wagstaff, A;van Doorslaer, E
通讯作者：
van Doorslaer, E
影响因子：
9.7
作者：
Xu, Ke;Evans, David B.;Evans, Timothy
通讯作者：
Evans, Timothy
DOI：
10.2471/blt.05.023739
发表时间：
2006-01-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Su, Tin Tin;Kouyaté, Bocar;Flessa, Steffen
通讯作者：
Flessa, Steffen
DOI：
10.1377/hlthaff.5.4.138
发表时间：
1986-01-01
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Berki, S E
通讯作者：
Berki, S E
影响因子：
168.9
作者：
Xu, K;Evans, DB;Murray, CJL
通讯作者：
Murray, CJL