居民现金卫生支出致贫影响分析:基于社区卫生综合改革典型城市居民健康询问调查  

The Impact of Out of Pocket Health Payment to Poverty for Residents:Based on Urban Residential Health Interview Survey of Typical Cities under Comprehensive Community Health Reform

作　　者：秦江梅[1] 毛璐[2] 张艳春[1] 张丽芳[1] 吴宁[1] 芮东升[2] 

机构地区：[1]卫生部卫生发展研究中心,北京100191 [2]石河子大学医学院,新疆石河子832002

出　　处：《中国卫生经济》2013年第9期62-64,共3页Chinese Health Economics

基　　金：中澳卫生与艾滋病项目(HSS409)

摘　　要：目的:比较8个社区卫生综合改革典型城市卫生筹资政策对居民现金卫生支出致贫的影响。方法:采用相关分析,探讨城镇居民人均可支配收入、卫生筹资结构与贫困发生率的关系。结果:现金卫生支出致贫影响最大人群是最贫困人群。结论:城市居民"因病致贫"随着卫生筹资结构中个人筹资的减少而得到缓解;居民现金卫生支出使贫困人群更加贫困,对富裕人群影响不大。Objective： To compare health financing mechanism on the impact of out of pocket health payments （OOP） impoverishment. Methods： Data were collected through household survey of 8 typical cities under comprehensive community health reform in 2011. The incidence of poverty and average poverty gap were calculated, and Spearman Correlation Analysis were adopted to analyze the relation between health financing structure and poverty incidence. Results： Using the urban poverty line （ urban lowest insurance line） as benchmark, OOP payment increased the poverty ratio by 1.1%, 2.5%, 3.4%, 1.3%, 1.9%, 2.6%, 0.8% and 0.3% percentage points in Hangzhou, Hefei, Wuhan, Chengdu, Wuxi, Tongling, Baoji and Shihezi, and OOP payment increase the average poverty gap by RMB 16.9, 32.3, 36.0, 9.4, 24.4, 20.3, 11.3 and 0.7 respectively in the 8 cities. The share of OOP health expenditure was positively correlated with the poverty rate after OOP health expenditure （r=0.790, P=0.020） . OOP health payments had a large influence on impoverishment. Conclusion： “Poverty because of illness” was relieved as the OOP payment reduced in health financing;OOP payment for health care will aggravate poverty of the poor, but its influence to the rich people is not great.

关 键 词：社区卫生服务 现金卫生支出 贫困发生率 贫困差距 

分 类 号：R197.1[医药卫生—卫生事业管理]