Payments for health care and its effect on catastrophe and impoverishment: Experience from the transition to Universal Coverage in Thailand
Payments for health care and its effect on catastrophe and impoverishment: Experience from the transition to Universal Coverage in Thailand
复制标题
DOI：
10.1016/j.socscimed.2008.09.047
复制
发表时间：
2008-12-01
影响因子：
5.4
通讯作者：
Lagrada, Leizel P.
中科院分区：
文献类型：
--
作者：
Somkotra, Tewarit;Lagrada, Leizel P.
2001年，当泰国开始实施全民覆盖（UC）政策时，公平的卫生筹资就体现在泰国医疗保健系统的改革战略中。本研究旨在衡量泰国家庭自费医疗保健支付的模式，并研究泰国过渡时期（全民覆盖政策实施前后）因此类支付而造成的金融灾难和贫困。本研究使用了 2000 年（加州大学之前）具有全国代表性的社会经济调查。 2002 年和 2004 年（UC 后），分别包含来自 24747、34758 和 34843 个个体家庭的数据。在观察期内，泰国家庭自付费用占家庭生活水平的比例呈现下降趋势。此外，从UC前到UC后时期，灾难性医疗保健付款的发生率和强度有所下降。五分位数的灾难性医疗保健支付的发生率分布和强度也表明，与较高五分位数群体相比，较低五分位数群体（第一和第二五分位数）所承受的灾难性医疗保健支付较低。 UC 政策还可以有效防止因自付费用医疗保健而导致的贫困，因为从 UC 前到 UC 后时期，贫困人数和贫困差距均有所下降。这项研究提供了重要证据，表明 UC 政策的实施是一项有价值的社会保护和安全网战略，有助于预防因自付费用医疗保健而导致的金融灾难和贫困。总之，泰国的 UC 政策实现了通过公平的医疗保健融资改善卫生系统的目标之一，通过减少因医疗保健自付费用而导致的金融灾难和贫困。 Crown 版权所有 (c) 2008 由 Elsevier Ltd 出版。保留所有权利。
Equitable health financing was embodied in the reform strategies of Thailand's health care system when the country moved towards implementing the Universal Coverage (UC) policy in 2001. This study aimed to measure the pattern of household out-of-pocket payments for health care and to examine the financial catastrophe and impoverishment due to such payments during the transitional period (pre- and post-Universal Coverage policy implementation) in Thailand. This study used the nationally representative Socioeconomic Surveys in 2000 (pre-UC). 2002, and 2004 (post-UC), which contained data from 24747, 34758 and 34843 individual households, respectively. The proportion of out-of-pocket payments for health care as a share of household living standards among Thai households shows a decreasing pattern during the observed period. Moreover, the incidence and intensity of catastrophic payments for health care decline from the pre-UC to post-UC period. The distribution of incidence and the intensity of catastrophic payments for health care across quintiles also indicate that the lower quintile group (1st and 2nd quintiles) incurs lower catastrophic health care payments compared to the higher quintile group. The UC policy is also effective in preventing impoverishment due to out-of-pocket payments for health care since both the poverty headcount and poverty gap decline from the pre-UC to post-UC period.This study provides important evidence that the UC policy implementation is a valuable social protection and safety net strategy that contributes to the prevention of financial catastrophe and impoverishment due to out-of-pocket payments for health care. In conclusion, the UC policy in Thailand achieves one of the goals of improving the health system through equitable health care financing by reducing financial catastrophe and impoverishment due to out-of-pocket payments for health care. Crown Copyright (c) 2008 Published by Elsevier Ltd. All rights reserved.