Economic and Social Research Institute, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, Ireland.
Soc Sci Med. 2009 Aug;69(3):379-86. doi: 10.1016/j.socscimed.2009.05.030. Epub 2009 Jun 18.
There are concerns that existing methods for analysing equity in Irish health care financing, based on progressivity index measures, are not adequately capturing patterns of inequity that occur in practice. This paper follows a new direction in the literature whereby equity in health care financing and delivery are analysed together. A flow of funds for Irish health care resources is developed and applied to data for 2004. The framework traces the flow of public and private health resources from individuals to financial intermediaries, from there to health care providers and functions, and from there to individuals. Individuals are categorised by health care entitlement status. Findings indicate that broad progressive patterns in aggregate resource flows hide less equitable patterns that require further attention and there are complex interactions between public and private resources. The flow of funds approach complements existing analytic methods and generates policy lessons for Irish and international policy makers.
人们担心,现有的基于累进指数衡量的爱尔兰医疗保健融资公平性分析方法,不能充分捕捉实际存在的不公平模式。本文在文献中开辟了一个新的方向,即将医疗保健融资和提供的公平性结合起来进行分析。为爱尔兰医疗保健资源开发了一个资金流动框架,并将其应用于 2004 年的数据。该框架追溯了公共和私人医疗资源从个人到金融中介机构、从那里到医疗服务提供者和功能、再到个人的流动情况。个人按医疗保健权益状况进行分类。研究结果表明,总体资源流动中的广泛累进模式掩盖了需要进一步关注的不公平模式,公共和私人资源之间存在复杂的相互作用。资金流动方法补充了现有的分析方法,并为爱尔兰和国际政策制定者提供了政策教训。