World Health Organization, Department of Health Systems Financing, Geneva, Switzerland.
J Health Econ. 2010 Jul;29(4):479-88. doi: 10.1016/j.jhealeco.2010.03.008. Epub 2010 Apr 2.
This article analyses the redistributive effect caused by health financing and the distribution of healthcare utilization in Argentina before and during the severe 2001/2002 economic crisis. Both dramatically changed during this period: the redistributive effect became much more positive and utilization shifted from pro-poor to pro-rich. This clearly demonstrates that when utilization is contingent on financing, changes can occur rapidly; and that an integrated approach is required when monitoring equity. From a policy perspective, the Argentine health system appears vulnerable to economic downturns mainly due to high reliance on out-of-pocket payments and the strong link between health insurance and employment.
本文分析了阿根廷在严重的 2001/2002 年经济危机前后，卫生筹资所产生的再分配效应和医疗服务利用的分配情况。在此期间，这两方面都发生了巨大变化：再分配效应变得更加积极，利用情况也从有利于穷人转向有利于富人。这清楚地表明，当利用取决于筹资时，变化可能会迅速发生；在监测公平性时，需要采取综合方法。从政策角度来看，阿根廷卫生系统似乎容易受到经济衰退的影响，主要原因是高度依赖自费支付和医疗保险与就业之间的紧密联系。
