Gender equity and health sector reform in Colombia: mixed state-market model yields mixed results.
Gender equity and health sector reform in Colombia: mixed state-market model yields mixed results.
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哥伦比亚的性别平等和卫生部门改革：混合的国家市场模式产生的结果好坏参半。
DOI：
10.1016/j.socscimed.2008.12.039
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发表时间：
2009
影响因子：
5.4
通讯作者：
A. Bello
中科院分区：
文献类型：
--
作者：
Christina Ewig;A. Bello
1993年，哥伦比亚进行了全面的保健改革，建立了一个由国家监督的单一保健系统，其中私营实体是主要的保险人和保健服务提供者，从而设法大幅度增加健康保险的覆盖面，减少国家对保健服务的参与。通过对家庭调查数据的定量比较和对改革内容的分析，我们评估了哥伦比亚卫生改革对性别公平的影响。我们发现，这些改革的几个方面有希望实现更大的性别平等，例如由此增加的妇女健康保险覆盖面。然而，由于歧视妇女的收费持续存在，以及采用了一种两级保健制度，其中女户主和穷人集中在一个质量较低的保健制度中，这些改革没有实现两性平等。
In 1993, Colombia carried out a sweeping health reform that sought to dramatically increase health insurance coverage and reduce state involvement in health provision by creating a unitary state-supervised health system in which private entities are the main insurers and health service providers. Using a quantitative comparison of household survey data and an analysis of the content of the reforms, we evaluate the effects of Colombia's health reforms on gender equity. We find that several aspects of these reforms hold promise for greater gender equity, such as the resulting increase in women's health insurance coverage. However, the reforms have not achieved gender equity due to the persistence of fees which discriminate against women and the introduction of a two-tier health system in which women heads of household and the poor are concentrated in a lower quality health system.