Sarti Simone, Terraneo Marco, Tognetti Bordogna Mara
Department of Social and Political Science, University of Milan, Italy.
Department of Sociology and Social Research, University of Milano-Bicocca, Italy.
Health Policy. 2017 Mar;121(3):307-314. doi: 10.1016/j.healthpol.2016.12.008. Epub 2017 Jan 6.
The global financial crisis that began in 2008 had an overall effect on the health behaviours of Italian households. Aggregate private health expenditures have decreased while the citizens have increasingly been asked to share health costs. The reduction of households' health expenditure could have serious consequences for health, especially if it concerns the most vulnerable people. The aim of this paper is to analyse the relation between poverty and household health expenditure, considering regional and social group variations. The data used stem from the "Family Expenditure Survey" collected by the Italian Statistical Institute (ISTAT) from 1997 to 2013. Results of multivariate analysis controlling for potential socio-demographic confounders show that the propensity to spend for poor families is decreased in the last years compared to not poor households. Meanwhile, among the households who spend, the average expenditure in euro seems to have been more stable over time. This is an alarming signal for the health of the most vulnerable households. These conditions could result in a gradual deterioration of health in poor families, which is likely to increase the burden on health systems in future. Hence, at this moment public intervention does not seem able to alleviate this situation.
始于2008年的全球金融危机对意大利家庭的健康行为产生了全面影响。总体私人医疗支出有所下降，而公民被要求承担的医疗费用却日益增加。家庭医疗支出的减少可能会对健康产生严重后果，尤其是涉及最弱势群体时。本文旨在分析贫困与家庭医疗支出之间的关系，并考虑地区和社会群体差异。所使用的数据源自意大利统计局（ISTAT）1997年至2013年收集的“家庭支出调查”。控制潜在社会人口混杂因素的多变量分析结果表明，与非贫困家庭相比，贫困家庭近年来的支出倾向有所下降。与此同时，在有支出的家庭中，以欧元计算的平均支出随着时间推移似乎更为稳定。这对最脆弱家庭的健康来说是一个警示信号。这些情况可能导致贫困家庭的健康状况逐渐恶化，未来很可能会增加医疗系统的负担。因此，目前公共干预似乎无法缓解这种局面。
