Catastrophic Healthcare Payments and Impoverishment in the Occupied Palestinian Territory
Catastrophic Healthcare Payments and Impoverishment in the Occupied Palestinian Territory
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DOI：
10.2165/11318200-000000000-00000
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发表时间：
2010-11-01
影响因子：
3.6
通讯作者：
Donaldson, Cam
中科院分区：
文献类型：
--
作者：
Mataria, Awad;Raad, Firas;Donaldson, Cam
背景：全球公认的重要性是，提供财政保护，使人们免受健康不良的风险，是任何卫生系统的主要业绩目标。这种类型的财务保护涉及最大限度地减少医疗保健的灾难性支付及其相关的破坏性影响。这一业绩目标的实现在很大程度上受到与每个国家的总体政策环境和社会政治背景有关的因素的影响。目标：研究1998年至2007年期间巴勒斯坦家庭承担的灾难性和灾难性的医疗保健支付的发生率和强度。这些影响的发病率和强度内的历史上独特的政策和社会经济背景下被占领的PalestinianTerritory.Methods：医疗保健支付被认为是灾难性的，如果它超过10%的家庭资源，或40%的资源净食品支出。通过比较支付医疗保健费用前后的贫困发生率和贫困程度，研究了医疗保健的减贫作用。数据来源是1998年和2004- 2007年的一系列年度支出和消费调查，包括巴勒斯坦家庭的代表性样本（每年n = 1 231 - 3 098）。家庭总支出被用来作为一个代理的家庭水平的资源和医疗产品和服务的综合清单上的家庭支出的总和被用来估计healthcare payment.Results：虽然只有约1%的受访家庭花费>= 40%的家庭总支出（净食品费用）在1998年的医疗保健，这一比例在2007年几乎翻了一番。在贫困效应方面，1998年，11.8%的被调查家庭由于医疗费用而陷入深度贫困，而2006年，12.5%的家庭由于同样的原因陷入深度贫困。在同一时期，贫困家庭由于医疗费用而未能达到深度贫困线的每月金额从9.4美元增加到12.9美元。结论：巴勒斯坦医疗保健系统无法抵御健康状况不佳的财务风险，这可能归因于巴勒斯坦被占领土的社会政治状况，以及一些内在的系统特征。建议推行扶贫融资计划，以减轻巴勒斯坦家庭经常受到的健康冲击的负面影响。
Background: Financial protection from the risks of ill health has globally recognized importance as a principal performance goal of any health system. This type of financial protection involves minimizing catastrophic payments for healthcare and their associated impoverishing effects. Realization of this performance goal is heavily influenced by factors related to the overall policy environment and sociopolitical context in each country.Objectives: To examine the incidence and intensity of catastrophic and impoverishing healthcare payments borne by Palestinian households between 1998 and 2007. The incidence and intensity of these effects are examined within the historically unique policy and socioeconomic context of the occupied Palestinian territory.Methods: A healthcare payment was considered catastrophic if it exceeded 10% of household resources, or 40% of resources net of food expenditures. The impoverishing effect of healthcare was examined by comparing poverty incidence and intensity before and after healthcare payments. The data source was a series of annual expenditure and consumption surveys covering 1998 and 2004-7, and including representative samples of Palestinian households (n = 1231-3098, per year). Total household expenditure was used as a proxy for household level of resources; and the sum of household expenses on a comprehensive list of medical goods and services was used to estimate healthcare payments.Results: While only around 1% of the surveyed households spent >= 40% of their total household expenditures (net of food expenses) on healthcare in 1998, the percentage was almost doubled in 2007. In terms of impoverishing effect, while 11.8% of surveyed households fell into deep poverty in 1998 due to healthcare payments, 12.5% of households entered deep poverty for the same reason in 2006. Over the same period, the monthly amount by which poor households failed to reach the deep poverty line due to healthcare payments increased from $US9.4 to $US12.9.Conclusions: The inability of the Palestinian healthcare system to protect against the financial risks of ill health could be attributed to the prevailing sociopolitical conditions of the occupied Palestinian territory, and to some intrinsic system characteristics. It is recommended that pro-poor financing schemes be pursued to mitigate the negative impact of the recurrent health shocks affecting Palestinian households.