Health Care Reform in the Former Soviet Union: Beyond the Transition
Health Care Reform in the Former Soviet Union: Beyond the Transition
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DOI：
10.1111/j.1475-6773.2011.01323.x
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发表时间：
2012-04-01
影响因子：
3.4
通讯作者：
McKee, Martin
中科院分区：
文献类型：
--
作者：
Balabanova, Dina;Roberts, Bayard;McKee, Martin
客观的。评估前苏联八个国家医疗保健的可及性和负担能力。数据来源/研究背景。 2010 年在亚美尼亚、阿塞拜疆、白俄罗斯、格鲁吉亚、哈萨克斯坦、摩尔多瓦、俄罗斯和乌克兰进行了初步数据收集。研究设计。使用多阶段分层随机抽样进行横断面家庭调查。数据收集/提取方法。使用标准化问卷收集 18 岁以上受试者的人口、社会经济和医疗保健获取特征的数据。使用描述性和多元回归分析。主要发现。近一半在上个月出现健康问题并认为需要护理的受访者并未寻求护理。受访者寻求医疗服务的可能性明显较低，其中包括生活在亚美尼亚、格鲁吉亚或乌克兰农村地区、年龄在 35-49 岁之间、家庭经济状况较差且饮酒量较高的人。费用最常被认为是不寻求医疗保健的原因。大多数获得护理的受访者都会自付费用，中位金额从白俄罗斯的 13 美元到阿塞拜疆的 100 美元不等。结论。过去十年来，获得医疗保健的机会和国内不平等似乎有所改善。然而，尽管努力改善财务保护，但仍然存在相当大的问题，包括自付费用和负担不起。
Objective. To assess accessibility and affordability of health care in eight countries of the former Soviet Union.Data Sources/Study Setting. Primary data collection conducted in 2010 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Moldova, Russia, and Ukraine.Study Design. Cross-sectional household survey using multistage stratified random sampling.Data Collection/Extraction Methods. Data were collected using standardized questionnaires with subjects aged 18+ on demographic, socioeconomic, and health care access characteristics. Descriptive and multivariate regression analyses were used.Principal Findings. Almost half of respondents who had a health problem in the previous month which they viewed as needing care had not sought care. Respondents significantly less likely to seek care included those living in Armenia, Georgia, or Ukraine, in rural areas, aged 35-49, with a poor household economic situation, and high alcohol consumption. Cost was most often cited as the reason for not seeking health care. Most respondents who did obtain care made out-of-pocket payments, with median amounts varying from $13 in Belarus to $100 in Azerbaijan.Conclusions. Access to health care and within-country inequalities appear to have improved over the past decade. However, considerable problems remain, including out-of-pocket payments and unaffordability despite efforts to improve financial protection.