中国卫生筹资的垂直公平与水平公平

The vertical and horizontal equity of health-care financing in China

[目的]评价中国卫生筹资系统的垂直公平与水平公平,为进一步的卫生筹资改革提供参考。[方法]利用《2015年中国社会状况综合调查》数据,运用Kakwani指数和PII指数,分析中国卫生筹资系统内三种主要筹资渠道的垂直公平和水平公平。[结果]卫生总筹资的Kakwani指数为-0.69746,具有累退性;政府卫生筹资的Kakwani指数位0.64078,社会卫生筹资的Kakwani指数为-0.01049,个人卫生筹资的Kakwani指数为-1.51316。[结论]政府卫生筹资垂直不公平程度最低,社会卫生筹资水平不公平程度最高,个人卫生筹资垂直不公平程度最高,但水平不公平程度最低。应优化卫生筹资结构,扩大社会医疗保险规模,以改善中国卫生筹资系统的公平性。

Objective To evaluate vertical and horizontal equity of China＇ s health financing system so as to provide reference for further health financing reform. Methods With the data of＂2015 Chinese Social Survey＂,Kakwani and PⅡ index were used to measure vertical and horizontal equity of three main financing channels in China＇ s health financing system. Results The Kakwani index of total health financing was-0. 69746,which was regressive,government＇ s was-0. 64078,society＇ s was-0. 01049,persona＇ s was-1. 51316. Conclusions Vertical unfair degree of government＇ s is the lowest,horizontal unfair degree of society＇ s is the highest,vertical unfair degree of persona＇ s is the highest,but it＇ s horizontal unfair degree is the lowest. In order to improve the equality of China＇ s health financing system,the health financing structure should be optimized and the scale of social medical insurance should be expanded.