Swiss Paraplegic Research, Health Services Statistics & Economics Group, Guido A. Zach Strasse 4., 6207, Nottwil, Switzerland.
Int J Equity Health. 2018 Aug 8;17(1):115. doi: 10.1186/s12939-018-0818-9.
Even with universal health coverage, people with long-term medical conditions can face financial hardship. However, financial hardship can be not only the result of an increase in health care costs; it has other socio-economic determinants that can cause social inequalities in terms of health. This study aims to estimate the impact of the place of residence on the financial hardship of people with spinal cord injury (SCI) in Switzerland. Switzerland is an interesting case to analyze because of its political system, where each of the 26 cantons is autonomous and responsible for raising its own income (through taxes) and providing public services.
Using cross-sectional data from the Swiss Spinal Cord Injury Cohort Study (SwiSCI), this paper estimates the probability of financial hardship by place of residence. The data set, recorded between 2011 and 2013, comprises information from 1549 participants aged 16 years and older, living with SCI.
The results show that people face different probabilities of financial hardship, depending on their place of residence. In general, people in the French-speaking cantons have a higher probability of financial hardship compared with people living in the German- or Italian-speaking cantons. People in the cantons of Geneva and Graubünden have almost five times the probability of financial hardship, compared with people in the canton with the lowest probability of financial hardship, Zug.
The place of residence is a determinant of the financial situation of a household where a member deals with a long-term health condition. The differences might arise due to variations in health care costs, the tax burden and social support system, which are regulated and administered by each canton.
即使实现了全民健康覆盖，患有长期疾病的人仍可能面临经济困难。然而，经济困难不仅是医疗费用增加的结果；它还有其他社会经济决定因素，可能导致健康方面的社会不平等。本研究旨在评估居住地对瑞士脊髓损伤（SCI）患者经济困难的影响。瑞士是一个有趣的分析案例，因为它的政治制度，26 个州中的每个州都是自治的，负责筹集自己的收入（通过税收）并提供公共服务。
本文使用瑞士脊髓损伤队列研究（SwiSCI）的横断面数据，按居住地估算经济困难的概率。该数据集记录了 2011 年至 2013 年间 1549 名 16 岁及以上的脊髓损伤患者的信息。
结果表明，人们面临不同的经济困难概率，这取决于他们的居住地。一般来说，说法语的州的居民比讲德语或意大利语的州的居民更有可能陷入经济困境。与居住在经济困难概率最低的楚格州的人相比，日内瓦州和格劳宾登州的居民陷入经济困境的可能性几乎高出五倍。
居住地是一个家庭中处理长期健康状况的成员的财务状况的决定因素。差异可能源于医疗保健费用、税收负担和社会支持系统的差异，这些都是由每个州来监管和管理的。
