在亚洲，谁为医疗保健付费？

Who pays for health care in Asia?

作者信息

O'Donnell Owen, van Doorslaer Eddy, Rannan-Eliya Ravi P, Somanathan Aparnaa, Adhikari Shiva Raj, Akkazieva Baktygul, Harbianto Deni, Garg Charu C, Hanvoravongchai Piya, Herrin Alejandro N, Huq Mohammed N, Ibragimova Shamsia, Karan Anup, Kwon Soon-man, Leung Gabriel M, Lu Jui-fen Rachel, Ohkusa Yasushi, Pande Badri Raj, Racelis Rachel, Tin Keith, Tisayaticom Kanjana, Trisnantoro Laksono, Wan Quan, Yang Bong-Min, Zhao Yuxin

机构信息

Department of Balkan, Slavic and Oriental Studies, University of Macedonia, 156 Egnatia Street, Thessaloniki 54006, Greece.

出版信息

J Health Econ. 2008 Mar;27(2):460-75. doi: 10.1016/j.jhealeco.2007.08.005. Epub 2007 Nov 29.

DOI:10.1016/j.jhealeco.2007.08.005

PMID:18179832

Abstract

We estimate the distributional incidence of health care financing in 13 Asian territories that account for 55% of the Asian population. In all territories, higher-income households contribute more to the financing of health care. The better-off contribute more as a proportion of ability to pay in most low- and lower-middle-income territories. Health care financing is slightly regressive in three high-income economies with universal social insurance. Direct taxation is the most progressive source of finance and is most so in poorer economies. In universal systems, social insurance is proportional to regressive. In high-income economies, the out-of-pocket (OOP) payments are proportional or regressive while in low-income economies the better-off spend relatively more OOP. But in most low-/middle-income countries, the better-off not only pay more, they also get more health care.

摘要

我们估算了占亚洲人口55%的13个亚洲地区医疗保健融资的分布性发生率。在所有地区，高收入家庭对医疗保健融资的贡献更大。在大多数低收入和中低收入地区，较富裕群体作为支付能力的一部分贡献更多。在三个实行全民社会保险的高收入经济体中，医疗保健融资略显累退。直接税是最具累进性的融资来源，在较贫穷的经济体中更是如此。在全民体系中，社会保险呈比例累退。在高收入经济体中，自付费用是成比例或累退的，而在低收入经济体中，较富裕群体的自付费用相对更多。但在大多数低收入/中等收入国家，较富裕群体不仅支付更多，还能获得更多医疗保健服务。