The welfare implications of public healthcare financing: a macro-micro simulation analysis of Uganda
The welfare implications of public healthcare financing: a macro-micro simulation analysis of Uganda
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DOI：
10.1093/heapol/czx125
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发表时间：
2017-12-01
影响因子：
3.2
通讯作者：
Smith, Richard D.
中科院分区：
文献类型：
--
作者：
Kabajulizi, Judith;Keogh-Brown, Marcus R.;Smith, Richard D.
关于全球卫生与发展的研究表明，疾病负担与一国的收入水平之间有很强的相关性。与高收入国家相比，贫穷国家因传染病、孕产妇、围产期和营养状况等可预防原因造成的死亡人数往往更多。在低收入国家，政府卫生支出在政府总预算中所占份额较低，自付医疗费用相对较高。它们还严重依赖外部资源提供保健资金，但外部资源流动的可持续性得不到保证。本文探讨了增加公共医疗卫生资金从国内资源调动，并评估了措施，以实现这一目标的部门增长和减贫率在乌干达使用动态可计算的一般均衡模型的影响。这篇文章表明，增加政府卫生预算份额，有利于扩大医疗保健服务，改善人口健康，提高部门增长和减少贫困。在国内税收和援助资金情景下，与服务业和工业部门相比，农业部门预计将实现最高增长，而到2020年，全国贫困人口预计将从31%下降到12%。这篇文章表明，最有效的措施是在医疗保健方面进行前期投资，并从专门用于健康的家庭税收中产生额外的国内健康资金。
Studies on global health and development suggest that there is a strong correlation between the burden of disease and a country's level of income. Poorer countries tend to suffer more deaths from preventable causes such as communicable, maternal, perinatal and nutritional conditions, compared with high-income countries. In low-income countries, the government health expenditure share in the general government budget is low and out-of-pocket payments for healthcare relatively high. They also rely heavily on external resources for health funding, yet sustainability of external resource flows is not guaranteed. This article explores increasing public healthcare funding from domestic resources mobilization, and evaluates the impact of measures to achieve this on sectoral growth and poverty reduction rates in Uganda using a dynamic computable general equilibrium model. This article shows that increasing the government health budget share, facilitates expanded healthcare services, improved population health, higher sectoral growth and reduced poverty. The agricultural sector is predicted to post the highest growth when compared with services and industry sectors under both domestic taxation and aid funding scenarios, while national poverty is predicted to decline from 31 to 12% of the population by 2020. This article demonstrates that the most effective measure is to frontload investment in healthcare and generate additional domestic funding for health from a household tax earmarked for health.