陕西省新农合参保人员健康结果公平性分析

Health Outcomes Equity among the People Insured in New Rural Cooperative Medical System in Shaanxi

目的研究新农合参保人员健康结果公平性程度,探讨影响参保人群健康结果公平性的关键因素,为完善医疗保障制度提供科学依据,为促进居民健康提供事实依据。方法采用经济分组法、收入五分法以及集中指数和集中曲线进行健康结果公平性分析,利用集中指数分解法测量与经济水平相关的健康结果的水平公平性。结果新农合参保人员两周患病率存在偏低收入者的健康结果不公平,经济水平较好的参保人员健康结果较差;慢性病患病率、自评健康不良率存在偏高收入者的健康结果不公平,经济水平较差的参保人员健康结果较差。结论经济水平是影响两周患病公平性的首要因素,年龄、文化程度,就业状况也是缓解健康结果不公平的因素。提高参保人群的经济水平、文化程度,改善就业状况对健康结果公平性有重要的作用。

Objective：To study the health equity and explore the influencing factors of health inequities among those insured in New Rural Cooperative Medical System and to provide theoretical and factual basis for improvement of medical insurance system through. Method： Using concentration index decomposition to explore the sources of inequity in health outcomes and the degree of horizontal inequity in health outcomes. ResultS：Economical level leads that the concentration indexes of two week prevalence favor the poor, i.e. the worse the health outcome of the rich is. Economical level leads that the concentration indexes of chronic disease prevalence and self - reported health defective rate favor the rich, i.e. the worse the health outcome of the poor is. Conclusion ： Economic level is the primary factors affecting two weeks prevalence, age, culture level, the employment situation is the factors al- leviate health outcomes unfair. Increase people＇s economic level and cultural level, improve the situation of em- ployment is important to the health equity.