家庭药品支出与巴西公共卫生系统中免费药品的作用。
Household expenditures for medicines and the role of free medicines in the Brazilian public health system.
机构信息
Programa de Pós-graduação em Saúde Coletiva, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil.
出版信息
Am J Public Health. 2011 May;101(5):916-21. doi: 10.2105/AJPH.2009.175844. Epub 2010 Aug 19.
OBJECTIVES
We sought to investigate, across different socioeconomic groups, the proportion of household medicine expenses that were paid by households and the proportion paid by the Brazilian national health system.
METHODS
We carried out a survey in Porto Alegre, Brazil, that included 2988 individuals of all ages. We defined 2 expenditure variables: "out-of-pocket medicines value" (the sum of retail prices of all medicines used by family members within the previous 15 days and paid for out of pocket) and "free medicines value" (a similar definition for medicines obtained without charge).
RESULTS
In 2003, the Brazilian national health system provided, free of charge, 78% of the monetary value of medicines reported (79% in the bottom wealth quintile and 32% in the top 2 quintiles). The mean out-of-pocket expense for medicines was 6 times greater among the top wealth quintiles compared with those in lower quintiles, but free medicines constituted a 3-times-greater proportion of potential expenditures for medicines among the bottom quintile than among the top 2 quintiles.
CONCLUSIONS
Free provision of medicines seems to be saving substantial amounts of medicine expenditures for poor people in Brazil.
目的
我们旨在调查不同社会经济群体中，家庭支付的药品费用占比和巴西国家卫生系统支付的药品费用占比。
方法
我们在巴西阿雷格里港开展了一项调查，共纳入 2988 名不同年龄段的个体。我们定义了 2 个支出变量：“自付药品价值”（家庭在过去 15 天内使用的所有药品的零售价格总和，需自费支付）和“免费药品价值”（用于无费用获取的药品的类似定义）。
结果
2003 年，巴西国家卫生系统免费提供了所报告药品货币价值的 78%（底层五分之一财富群体为 79%，前两个五分之一财富群体为 32%）。与较低财富五分位数相比，最高财富五分位数的药品自付费用平均高出 6 倍，但在底层五分位数中，免费药品占潜在药品支出的比例比前两个五分位数高 3 倍。
结论
在巴西，免费提供药品似乎为贫困人群节省了大量药品支出。
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