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印度尼西亚医疗保健的社会风险管理选项。

Social risk management options for medical care in Indonesia.

作者信息

Pradhan Menno, Prescott Nicholas

机构信息

Economic and Social Institute, Free University, Amsterdam, The Netherlands.

出版信息

Health Econ. 2002 Jul;11(5):431-46. doi: 10.1002/hec.689.

Abstract

This paper investigates the extent to which price subsidies for medical care are a suitable instrument to reduce household's exposure to catastrophic financial risks associated with ill-health in Indonesia. Using the 1995 SUSENAS household survey, the observed distribution of user fees and health expenditures is used to derive a distribution of 'needed' medical expenditures. The trade-off between the tax burden and effectiveness in reducing the exposure to catastrophic risk is analyzed for two existing price regimes along with a number of hypothetical regimes. We find that the existing regimes significantly reduce the exposure to catastrophic shocks but do not eliminate them. Simulations suggest that further reductions could be achieved if a larger proportion of government subsidies were directed to inpatient care. Subsidizing outpatient treatment is a cost effective policy to reduce exposure to catastrophic risks only for the very poor.

摘要

本文研究了医疗价格补贴在多大程度上是一种合适的手段,用以降低印度尼西亚家庭因健康问题而面临灾难性财务风险的可能性。利用1995年的全国社会经济调查(SUSENAS)家庭调查数据,通过观察到的用户费用和医疗支出分布来推导“所需”医疗支出的分布。针对两种现有价格制度以及一些假设制度,分析了税收负担与降低灾难性风险可能性的有效性之间的权衡。我们发现,现有制度显著降低了面临灾难性冲击的可能性,但并未消除这些冲击。模拟结果表明,如果将更大比例的政府补贴用于住院治疗,可能会进一步降低这种可能性。只有对极贫困人群而言,补贴门诊治疗才是降低面临灾难性风险可能性的一种具有成本效益的政策。

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