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中国国家医疗保障制度的公平性和效益研究。

A study on the equality and benefit of China's national health care system.

机构信息

School of Public Administration, Northwest University, 1 Xuefu Road, Chang'an District, Xi'an, Shaanxi, 710127, China.

School of Politics and Administration, Xianyang Normal University, Wenlin Road, Xianyang, Shaanxi, 712000, China.

出版信息

Int J Equity Health. 2017 Aug 29;16(1):155. doi: 10.1186/s12939-017-0653-4.

Abstract

BACKGROUND

This study is designed to evaluate whether the benefit which the residents received from the national health care system is equal in China. The perceived equality and benefit are used to measure the personal status of health care system, health status. This study examines variations in perceived equality and benefit of the national health care system between urban and rural residents from five cities of China and assessed their determinants.

METHODS

One thousand one hundred ninty eight residents were selected from a random survey among five nationally representative cities. The research characterizes perceptions into four population groupings based on a binary assessment of survey scores: high equality & high benefit; low equality & low benefit; high equality & low benefit; and low equality & high benefit.

RESULTS

The distribution of the four groups above is 30.4%, 43.0%, 4.6% and 22.0%, respectively. Meanwhile, the type of health insurance, educational background, occupation, geographic regions, changes in health status and other factors have significant impacts on perceived equality and benefit derived from the health care system.

CONCLUSION

The findings demonstrate wide variations in perceptions of equality and benefit between urban and rural residents and across population characteristics, leading to a perceived lack of fairness in benefits and accessibility. Opportunities exist for policy interventions that are targeted to eliminate perceived differences and promote greater equality in access to health care.

摘要

背景

本研究旨在评估中国居民从国家医疗保健系统中获得的利益是否平等。感知的公平性和收益用于衡量医疗保健系统的个人地位和健康状况。本研究考察了中国五个城市城乡居民对国家医疗保健系统的感知公平性和收益的差异,并评估了其决定因素。

方法

从全国五个具有代表性的城市中随机抽取 1198 名居民进行了调查。该研究根据调查分数的二元评估,将感知划分为四个人群分组:高公平高收益;低公平低收益;高公平低收益;低公平高收益。

结果

上述四个组的分布分别为 30.4%、43.0%、4.6%和 22.0%。同时,医疗保险类型、教育背景、职业、地理位置、健康状况变化等因素对感知公平性和从医疗保健系统中获得的收益有显著影响。

结论

研究结果表明,城乡居民和不同人口特征之间对公平性和收益的感知存在广泛差异,导致对收益和可及性的公平性缺乏感知。存在政策干预的机会,可以针对消除感知差异并促进更公平地获得医疗保健的目标进行干预。

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