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救助计划是否已将医疗保健费用的负担从国家转移到了个人身上?

Have bailouts shifted the burden of paying for healthcare from the state onto individuals?

作者信息

Loughnane Conor, Murphy Aileen, Mulcahy Mark, McInerney Celine, Walshe Valerie

机构信息

Cork University Business School, University College Cork, Cork, Ireland.

Health Service Executive, Model Business Park, Model Farm Road, Cork, Ireland.

出版信息

Ir J Med Sci. 2019 Feb;188(1):5-12. doi: 10.1007/s11845-018-1798-x. Epub 2018 Apr 9.

Abstract

BACKGROUND/AIMS: The financial crisis that enveloped Europe in 2009 created financial pressure for governments and required a number of countries to obtain a financial bailout from the IMF. The purpose of this paper is to examine the effect of the financial crisis on public health expenditure in bailout countries and if bailouts shift the burden of paying for healthcare from the state onto individuals.

METHODS

Quantitative health expenditure data were collected from the WHO and OECD for the period 2004-2015 and evaluated using a comparison of means Welch's t test.

RESULTS

The majority of bailout countries recorded a decrease in public health expenditure as a percentage of total government expenditure, with Ireland recording the largest decrease with government health expenditure as a percentage of total government expenditure, falling by 22% (P < .01). In addition, the results also suggest that the burden of paying for healthcare shifted from the state onto individuals in three countries, namely Hungary, Ireland and Portugal, where public health expenditure declined and private expenditure increased significantly.

CONCLUSIONS

The ramifications of shifting the burden of paying for healthcare from the state onto individuals at this point remain unclear with further research required to identify the long-term consequences for healthcare.

摘要

背景/目的:2009年席卷欧洲的金融危机给各国政府带来了财政压力,许多国家需要从国际货币基金组织获得财政援助。本文旨在研究金融危机对接受援助国家公共卫生支出的影响,以及援助是否将医疗保健支付负担从国家转移到个人身上。

方法

收集了世界卫生组织和经济合作与发展组织2004 - 2015年期间的定量卫生支出数据,并使用均值比较的韦尔奇t检验进行评估。

结果

大多数接受援助的国家公共卫生支出占政府总支出的百分比有所下降,爱尔兰下降幅度最大,政府卫生支出占政府总支出的百分比下降了22%(P < 0.01)。此外,结果还表明,在匈牙利、爱尔兰和葡萄牙这三个国家,医疗保健支付负担从国家转移到了个人身上,这三个国家的公共卫生支出下降,私人支出显著增加。

结论

目前将医疗保健支付负担从国家转移到个人身上的影响尚不清楚,需要进一步研究以确定对医疗保健的长期后果。

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