Health Economics Unit, Department of Public Health and Family Medicine, University of Cape Town, Health Sciences Faculty, Observatory, South Africa.
Health Policy Plan. 2011 Mar;26(2):174-82. doi: 10.1093/heapol/czq031. Epub 2010 Aug 4.
Benefit incidence analysis (BIA) considers who (in terms of socio-economic groups) receive what benefit from using health services. While traditionally BIA has focused on only publicly funded health services, to assess whether or not public subsidies are 'pro-poor', the same methodological approach can be used to assess how well the overall health system is performing in terms of the distribution of service benefits. This is becoming increasingly important in the context of the growing emphasis on promoting universal health systems. To conduct a BIA, a household survey dataset that incorporates both information on health service utilization and some measure of socio-economic status is required. The other core data requirement is unit costs of different types of health service. When utilization rates are combined with unit costs for different health services, the distribution of benefits from using services, expressed in monetary terms, can be estimated and compared with the distribution of the need for health care. This paper aims to provide an introduction to the methods used in the 'traditional' public sector BIA, and how the same methods can be applied to undertake an assessment of the whole health system. We consider what data are required, potential sources of data, deficiencies in data frequently available in low- and middle-income countries, and how these data should be analysed.
受益归属分析（BIA）考虑的是使用卫生服务的人群（按社会经济群体划分）从中获得了哪些收益。传统上，BIA 主要关注的是公共资金资助的卫生服务，为了评估公共补贴是否“有利于穷人”，可以采用相同的方法来评估整个卫生系统在服务效益分配方面的表现。在越来越强调促进全民健康系统的背景下，这一点变得越来越重要。要进行 BIA，需要一个包含卫生服务利用信息和某种社会经济地位衡量标准的家庭调查数据集。另一个核心数据要求是不同类型卫生服务的单位成本。当利用率与不同卫生服务的单位成本相结合时，可以估算服务使用带来的收益分布（以货币形式表示），并将其与卫生保健需求的分布进行比较。本文旨在介绍“传统”公共部门 BIA 中使用的方法，以及如何应用相同的方法对整个卫生系统进行评估。我们考虑了所需的数据、数据的潜在来源、在中低收入国家中经常缺乏的数据的缺陷，以及应该如何分析这些数据。
