卫生服务的公平性研究进展

Progress in the research on the fairness of health services

公平在卫生经济政策中具有特殊重要性 ,主要有以下 3方面的含义 :健康状况的公平性 ,卫生服务提供中的公平性以及卫生筹资中的公平性。传统的公平性测量方法有极差法、洛伦兹曲线与基尼系数、差异指数、不平等的斜率指数及相对指数、综合曲线法。最近世界卫生组织提出了 3个新的公平性指标及其测量方法 ,即 :儿童成活率分布指数和伤残调整期望寿命 (DALE)来衡量居民健康的公平性、反应性来表示卫生服务提供过程中的公平性和资金贡献公平合理性指数来表示卫生服务筹资的公平性。

Fairness, which is of special importance to health economy policies, has the following three major implications: fairness of the state of health, fairness of the delivery of health services and fairness of health fundraising. Traditional methods for measuring fairness include those of range, Lorentz curve, Jeany coefficient, difference index, and, for measuring unfairness, those of slope index, relative index and comprehensive curve. Recently WHO put forward 3 new fairness indexes and measurement methods, viz. measuring the fairness of residents health via the distribution index of child survival rate and disability adjusted life expectancy; measuring the fairness of the delivery of health services via reactivity; and measuring the fairness of health fundraising via the fairness and reasonableness index for the contributions of funds.