新疆生产建设兵团城市和团场卫生筹资累进性分析  

Progressivity Analysis of Urban and Tuanchang Health Financing in Xinjiang Production and Construction Corps

作　　者：刘涵[1] 秦江梅[2] 刘翔[1] 许东霞[1] 柴培培[2] 毛璐[1] 

机构地区：[1]石河子大学医学院预防医学系,新疆石河子832002 [2]卫生部卫生发展研究中心

出　　处：《中国卫生事业管理》2012年第11期812-814,共3页Chinese Health Service Management

摘　　要：了解2010年新疆生产建设兵团卫生筹资在城市和团场间的分布,评价各项卫生筹资渠道的公平性。方法:计算家庭可支付能力、直接税、间接税、社会医疗保险、商业健康保险和现金卫生支出在不同经济组构成及集中指数和Kakwani指数。结果:城乡五项卫生筹资渠道比较,仅直接税城市与团场不同经济水平组分布差异有统计学意义(χ2=21.496,P=0.000);兵团城市和团场各项卫生支出的集中指数均为正值,说明富裕家庭卫生筹资水平高于经济水平低的家庭;城市各项筹资渠道的Kakwani指数从大到小依次为直接税、现金卫生支出、社会医疗保险、商业健康保险、间接税,团场依次为直接税、现金卫生支出、商业健康保险、社会医疗保险、间接税。结论:兵团城市和团场家庭的直接税、社会医疗保险、商业健康保险和现金卫生支出四项筹资渠道是累进的,现行卫生筹资有利于缩小社会相对贫富差距。The Chinese Health Service Management. Abstract Objective To analyze the distribution of urban and Tuanchang health financing in Xinjiang Production and Construction Corps in 2010 and evaluate the equity of different health financing sources. Methods Calculating the ability to pay , direct tax,indirect tax, social health security expenditure, private health insurance expenditure, out-of-pocket health expenditure of household in different economic levels and the concentration index （CI） and Kakwani index. Results Comparison of five health fi- nancing sources in urban and Tuanchang, only direct tax is distributed significantly different between urban and Tuanchang in dif- ferent economic levels（ χ2 = 21. 496, P = 0. 000） ;the CI of the five health financing sources in urban and Tuanchang are all positive, reflecting that the health financing level of rich family is higher than that of low economic level family;the decreasing order of Kakwani index in urban is direct tax, out-of-picket health expenditure, social health security expenditure, private health insurance expenditure and indirect tax;the decreasing order of Kakwani index in Tuanchang is direct tax,out-of-picket health expenditure, private health insurance expenditure, social health security expenditure and indirect tax. Conclusion Direct tax, social health secur- ity expenditure,private health insurance expenditure, and out-of＇picket health expenditure are progressive in urban and Tuan-chang, which can reduce the relative economic gap in different economic groups.

关 键 词：卫生筹资 累进性 集中指数 Kakwani指数 

分 类 号：R197.1[医药卫生—卫生事业管理]