How to do (or not to do) … a health financing incidence analysis.
How to do (or not to do) … a health financing incidence analysis.
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DOI：
10.1093/heapol/czx188
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发表时间：
2018-04-01
影响因子：
3.2
通讯作者：
Wiseman V
中科院分区：
文献类型：
--
作者：
Ataguba JE;Asante AD;Limwattananon S;Wiseman V
筹资发生率分析(FIA)评估卫生筹资负担是如何与家庭支付能力(ATP)分配的。在累进融资系统中，与富裕家庭相比，较贫穷家庭为卫生服务提供的ATP比例较小。当穷人按比例贡献更多资金时，一个体系就是倒退的。公平的卫生筹资往往与进步性有关。为了进行全面的FIA，需要详细的家庭调查数据，其中包含关于家庭ATP的基本衡量标准的可靠信息，以及通过税收、医疗保险和自付(OOP)付款来提取对医疗服务的贡献的变量。此外，需要关于卫生筹资组合的数据来评估整个FIA。本文描述的进行FIA的两种主要方法包括结构累进性方法和有效累进性方法，结构累进性方法评估用于卫生服务的ATP份额(例如收入)如何按分位数变化，有效累进性方法使用累进性指数，如Kakwani指数。本文为分析人员进行FIA提供了一些详细的实践步骤。这包括数据要求、数据来源、如何从调查数据中提取或估计医疗费用以及评估FIA的方法。它还讨论了许多低收入和中等收入国家(LMIC)常见的数据缺陷。FIA的结果有助于制定政策以实现公平的卫生系统。
Financing incidence analysis (FIA) assesses how the burden of health financing is distributed in relation to household ability to pay (ATP). In a progressive financing system, poorer households contribute a smaller proportion of their ATP to finance health services compared to richer households. A system is regressive when the poor contribute proportionately more. Equitable health financing is often associated with progressivity. To conduct a comprehensive FIA, detailed household survey data containing reliable information on both a cardinal measure of household ATP and variables for extracting contributions to health services via taxes, health insurance and out-of-pocket (OOP) payments are required. Further, data on health financing mix are needed to assess overall FIA. Two major approaches to conducting FIA described in this article include the structural progressivity approach that assesses how the share of ATP (e.g. income) spent on health services varies by quantiles, and the effective progressivity approach that uses indices of progressivity such as the Kakwani index. This article provides some detailed practical steps for analysts to conduct FIA. This includes the data requirements, data sources, how to extract or estimate health payments from survey data and the methods for assessing FIA. It also discusses data deficiencies that are common in many low- and middle-income countries (LMICs). The results of FIA are useful in designing policies to achieve an equitable health system.
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影响因子：
8.1
作者：
Asante AD;Irava W;Limwattananon S;Hayen A;Martins J;Guinness L;Ataguba JE;Price J;Jan S;Mills A;Wiseman V
通讯作者：
Wiseman V
影响因子：
3.2
作者：
KAKWANI, NC
通讯作者：
KAKWANI, NC
影响因子：
1.5
作者：
BISHOP, JA;CHOW, KV;FORMBY, JP
通讯作者：
FORMBY, JP
影响因子：
9.7
作者：
Dominguez Uga, Maria Alicia;Santos, Isabela Soares
通讯作者：
Santos, Isabela Soares
DOI：
10.2307/134264
发表时间：
1976-01-01
影响因子：
1.6
作者：
KHETAN, CP;PODDAR, SN
通讯作者：
PODDAR, SN