O'Donnell Owen
Department of Balkan, Slavic and Oriental Studies, University of Macedonia, 156 Egnatia Street, Thessaloniki, Greece.
Cad Saude Publica. 2007 Dec;23(12):2820-34. doi: 10.1590/s0102-311x2007001200003.
Effective health care interventions are underutilized in the developing world, and income-related disparities in use are large. The evidence concerning this access problem is summarized and its demand side causes are identified. Broad strategies that have been proposed to tackle the access problem through changes in economic incentives are considered. It is argued that there is a need to go beyond the identification of broad strategies to the design and evaluation of specific policy measures. Only through experimentation and evaluation will we learn what works in raising health care utilization, particularly among the poor in the developing world.
有效的医疗保健干预措施在发展中国家未得到充分利用,而且在使用方面与收入相关的差距很大。本文总结了有关这一获取问题的证据,并确定了其需求方的原因。还考虑了通过改变经济激励措施来解决获取问题而提出的广泛战略。有人认为,有必要超越确定广泛战略,转向设计和评估具体政策措施。只有通过试验和评估,我们才能了解哪些措施在提高医疗保健利用率方面有效,特别是在发展中国家的贫困人口中。