CAPP, Instituto Superior de Ciências Sociais e Políticas, Universidade de Lisboa, Portugal; CICS.NOVA, Centro Interdisciplinar de Ciências Sociais, Universidade Nova de Lisboa, Portugal.
Department of Economics, Ca' Foscari University of Venice, Italy; Health Econometrics and Data Group, University of York, UK.
Health Policy. 2017 Oct;121(10):1063-1071. doi: 10.1016/j.healthpol.2017.08.011. Epub 2017 Sep 18.
Despite the sizeable cuts in public healthcare spending, which were part of the austerity measures recently undertaken in Southern European countries, little attention has been devoted to monitoring its distributional consequences in terms of healthcare use. This study aims at measuring socioeconomic inequities in primary and secondary healthcare use experienced some time after the crisis onset in Italy, Spain and Portugal. The analysis, based on data drawn from the Survey of Health, Ageing and Retirement in Europe (SHARE), focuses on older people, who generally face significantly higher healthcare needs, and whose health appeared to have worsened in the aftermath of the crisis. The Horizontal Inequity indexes reveal remarkable socioeconomic inequities in older people's access to secondary healthcare in all three countries. In Portugal, the one country facing most severe healthcare budget cuts and where user charges apply also to GP visits, even access to primary care exhibits a significant pro-rich concentration. If reducing inequities in older people's access to healthcare remains a policy objective, austerity measures maybe pulling the Olive belt countries further away from achieving it.
尽管南欧国家最近采取了紧缩措施,大幅削减了公共医疗支出,但很少有人关注监测其在医疗利用方面的分配后果。本研究旨在衡量意大利、西班牙和葡萄牙危机爆发后一段时间内初级和二级医疗保健使用方面的社会经济不平等。该分析基于来自欧洲健康、老龄化和退休调查(SHARE)的数据,重点关注老年人,他们通常面临更高的医疗保健需求,而且他们的健康状况在危机后似乎恶化了。水平不公平指数显示,在所有三个国家,老年人获得二级医疗保健的机会都存在显著的社会经济不平等。在葡萄牙,这个面临最严重医疗预算削减和对全科医生就诊收取费用的国家,甚至初级保健的获得也表现出明显的有利于富人的集中。如果减少老年人获得医疗保健方面的不平等仍然是一个政策目标,那么紧缩措施可能会使这些“橄榄油带”国家进一步偏离这一目标。