Xu Ke, Evans David B, Carrin Guido, Aguilar-Rivera Ana Mylena, Musgrove Philip, Evans Timothy
Department of Health Systems Financing, Health Systems and Services, World Health Organization, Geneva, Switzerland.
Health Aff (Millwood). 2007 Jul-Aug;26(4):972-83. doi: 10.1377/hlthaff.26.4.972.
Many countries rely heavily on patients' out-of-pocket payments to providers to finance their health care systems. This prevents some people from seeking care and results in financial catastrophe and impoverishment for others who do obtain care. Surveys in eighty-nine countries covering 89 percent of the world's population suggest that 150 million people globally suffer financial catastrophe annually because they pay for health services. Prepayment mechanisms protect people from financial catastrophe, but there is no strong evidence that social health insurance systems offer better or worse protection than tax-based systems do.
许多国家严重依赖患者自掏腰包向医疗服务提供者付费，以此为其医疗保健系统筹集资金。这使得一些人无法寻求医疗服务，还导致另一些获得医疗服务的人陷入经济灾难和贫困。对覆盖全球89%人口的89个国家进行的调查表明，全球每年有1.5亿人因支付医疗服务费用而遭受经济灾难。预付机制可保护人们免遭经济灾难，但没有有力证据表明社会医疗保险系统提供的保障比基于税收的系统更好或更差。
