家庭卫生筹资公平性研究

Research on fairness in the financial contributions of households to the health system

目的 测算上海市郊区家庭卫生筹资公平性状况 ,并估计全国情况。方法 通过家庭入户调查获得卫生支出、政府卫生投入等数据 ,应用WHO所介绍的卫生系统绩效评价中的家庭卫生筹资公平性指标及其测量方法。结果 测算出家庭卫生筹资公平性系数为 0 735 ;合作医疗覆盖率能提高家庭卫生筹资公平性。结论 上海市郊区家庭卫生筹资公平性水平与WHO对我国的估计相符 ,而全国的筹资公平性水平要更低 ;WHO所推荐的卫生筹资公平性测算方法中 ,政府对家庭卫生补贴的测算不适合我国实情。

Objective To estimate fairness in the financial contributions of suburban households of Shanghai to the health system and the situation throughout the country. Methods A household survey was conducted to obtain data on health expenditure and government health input, which was then analyzed by means of the index for and methodology of fairness in the financial contributions of households in the performance assessment of the health system as introduced by the WHO. Results The coefficient of fairness in the financial contributions of households to the health system was estimated to be 0.735 and the rate of cooperative medical care coverage was positively related to the fairness. Conclusion The fairness level of the financial contributions of suburban households of Shanghai to the health system tallies with the level estimated by the WHO for China while the national level is lower. The calculations of government subsidy for household health, as recommended by the WHO in estimating fairness in the financial contributions to the health system, do not conform to the actual situation in China.