London School of Hygiene and Tropical Medicine, Faculty of Public Health and Policy, 15-17 Tavistock Place, London, WC1H 9SH, UK.
Health Serv Res. 2012 Apr;47(2):840-64. doi: 10.1111/j.1475-6773.2011.01323.x. Epub 2011 Sep 23.
To assess accessibility and affordability of health care in eight countries of the former Soviet Union.
DATA SOURCES/STUDY SETTING: Primary data collection conducted in 2010 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Moldova, Russia, and Ukraine.
Cross-sectional household survey using multistage stratified random sampling.
DATA COLLECTION/EXTRACTION METHODS: Data were collected using standardized questionnaires with subjects aged 18+ on demographic, socioeconomic, and health care access characteristics. Descriptive and multivariate regression analyses were used.
Almost half of respondents who had a health problem in the previous month which they viewed as needing care had not sought care. Respondents significantly less likely to seek care included those living in Armenia, Georgia, or Ukraine, in rural areas, aged 35-49, with a poor household economic situation, and high alcohol consumption. Cost was most often cited as the reason for not seeking health care. Most respondents who did obtain care made out-of-pocket payments, with median amounts varying from $13 in Belarus to $100 in Azerbaijan.
Access to health care and within-country inequalities appear to have improved over the past decade. However, considerable problems remain, including out-of-pocket payments and unaffordability despite efforts to improve financial protection.
评估前苏联八国的医疗保健可及性和负担能力。
资料来源/研究地点：2010 年在亚美尼亚、阿塞拜疆、白俄罗斯、格鲁吉亚、哈萨克斯坦、摩尔多瓦、俄罗斯和乌克兰进行的实地数据收集。
采用多阶段分层随机抽样的横断面家庭调查。
资料收集/提取方法：使用标准化问卷对 18 岁以上的人口进行调查，内容涉及人口统计学、社会经济和医疗保健获取特征。采用描述性和多元回归分析。
近一半在过去一个月内有健康问题且认为需要治疗的受访者并未寻求治疗。不太可能寻求治疗的受访者包括居住在亚美尼亚、格鲁吉亚或乌克兰、农村地区、年龄在 35-49 岁之间、家庭经济状况较差、饮酒量高的受访者。不寻求医疗保健的主要原因是费用。大多数获得治疗的受访者都自掏腰包支付费用，从白俄罗斯的 13 美元到阿塞拜疆的 100 美元不等。
过去十年中，医疗保健的可及性和国内不平等似乎有所改善。然而，仍然存在相当多的问题，包括自费支付和尽管有改善财务保护的努力但仍难以负担。
