Musango Laurent, Dujardin Bruno, Dramaix Michèle, Criel Bart
Ministère de la Santé, Kigali, Rwanda.
Trop Med Int Health. 2004 Nov;9(11):1222-7. doi: 10.1111/j.1365-3156.2004.01318.x.
The establishment of mutual health insurance systems is one of the priorities of the Rwandan government. Pilot studies have been conducted in three districts of the country. Nonetheless, after 4 years of implementation (1999-2003), the population coverage by these insurance systems remains relatively low. A cross-sectional study of 1042 households in the Kabutare health district allowed for a comparison of socio-economic and demographic variables, and the medical, surgical, gynaecological, and obstetrical history of health insurance scheme members and non-members. The results of the study demonstrate that the distribution of members and non-members is similar in terms of sex, marital status, professional status and medical history. However, larger households (more than five members) and those having a relatively higher income (more than USD 230 per annum) are more likely to be insured than other households. Members of the mutual health insurance use more the health services than non-members, spend less on health care and increasingly maintain membership. The study emphasizes the relevance to further promote mutual health insurance, but also points to the need for mechanisms to ensure financial access for the poor rural population.
建立互助医疗保险制度是卢旺达政府的优先事项之一。该国已在三个地区开展了试点研究。然而，经过4年的实施（1999 - 2003年），这些保险制度的人口覆盖率仍然相对较低。对卡布塔雷健康区1042户家庭进行的横断面研究，比较了社会经济和人口变量，以及医疗保险计划参保人员和非参保人员的医疗、外科、妇科和产科病史。研究结果表明，参保人员和非参保人员在性别、婚姻状况、职业状况和病史方面分布相似。然而，大家庭（五口以上）和收入相对较高（每年超过230美元）的家庭比其他家庭更有可能参保。互助医疗保险的参保人员比非参保人员更多地使用医疗服务，医疗保健支出更少，并且越来越多地维持参保状态。该研究强调了进一步推广互助医疗保险的重要性，但也指出需要建立机制，以确保贫困农村人口能够获得资金支持。
