Catastrophic payments for health care in Asia
Catastrophic payments for health care in Asia
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DOI：
10.1002/hec.1209
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发表时间：
2007-11-01
期刊：
影响因子：
2.1
通讯作者：
Zhao, Yuxin
中科院分区：
文献类型：
--
作者：
Van Doorslaer, Eddy;O'Donnell, Owen;Zhao, Yuxin
自付费用 (OOP) 是亚洲大部分地区医疗保健融资的主要方式。我们估计了占亚洲人口 81% 的 14 个国家和地区的 OOP 医疗保健支付的规模和分布。我们重点关注灾难性的支付，即严重扰乱家庭生活水平的支付，并通过那些吸收大部分家庭资源的支付来近似此类支付。孟加拉国、中国、印度、尼泊尔和越南对 OOP 融资的依赖程度最高，灾难性付款的发生率最高。斯里兰卡、泰国和马来西亚作为中低收入国家脱颖而出，它们限制了卫生融资中的 OOP 份额和直接支付的灾难性影响。在大多数低/中等收入国家，富裕人群更有可能将家庭总资源的很大一部分用于医疗保健。这可能反映了最贫困人口无法将资源用于其他基本需求，也可能反映了一些国家向穷人提供的使用费保护。但在中国、吉尔吉斯斯坦和越南，穷人都不能免缴费用，他们很可能甚至更有可能遭受灾难性的付款。版权所有 (C) 2007 John Wiley & Sons, Ltd.
Out-of-pocket (OOP) payments are the principal means of financing health care throughout much of Asia. We estimate the magnitude and distribution of OOP payments for health care in fourteen countries and territories accounting for 81 % of the Asian population. We focus on payments that are catastrophic, in the sense of severely disrupting household living standards, and approximate such payments by those absorbing a large fraction of household resources. Bangladesh, China, India, Nepal and Vietnam rely most heavily on OOP financing and have the highest incidence of catastrophic payments. Sri Lanka, Thailand and Malaysia stand out as low to middle income countries that have constrained both the OOP share of health financing and the catastrophic impact of direct payments. In most low/middle-income countries, the better-off are more likely to spend a large fraction of total household resources on health care. This may reflect the inability of the poorest of the poor to divert resources from other basic needs and possibly the protection of the poor from user charges offered in some countries. But in China, Kyrgyz and Vietnam, where there are no exemptions of the poor from charges, they are as, or even more, likely to incur catastrophic payments. Copyright (C) 2007 John Wiley & Sons, Ltd.