约旦医疗保险拥有状况的决定因素：2017-2018 年人口与家庭健康调查的横断面研究。
Determinants of health insurance ownership in Jordan: a cross-sectional study of population and family health survey 2017-2018.
机构信息
School of Business, Guilin University of Electronic Technology, Guilin, China.
School of Physical Education, Research Center of Sports and Health, Wuhan Business University, Wuhan, China.
出版信息
BMJ Open. 2021 Mar 4;11(3):e038945. doi: 10.1136/bmjopen-2020-038945.
OBJECTIVES
With about one-third of the population living below the poverty line, Jordan faces major healthcare, social and national development issues. Low insurance coverage among the poor and high out-of-pocket expenditure worsens the financial insecurity especially for the marginalised population. The Government of Jordan aims to achieve universal coverage of health insurance-a bold plan that requires research evidence for successful implementation. In this study, we aimed to assess the proportion of the population covered by any health insurance, and the determinants owing a health insurance.
DESIGN
A population-based prospective cohort study.
SETTING
Jordan.
METHODS
Data for this study were derived from the Jordan Population and Family Health Survey, which was implemented by the Department of Statistics from early October 2017 to January 2018. Sample characteristics were described as percentages with 95% CIs. Binary logistic regression models were used to estimate OR of health insurance ownership. Parsimonious model was employed to assess the sex and geographical differences.
RESULTS
Data revealed that in 2017-2018, 73.13% of the 12 992 men and women had health insurance. There was no indication of age of sex difference in health insurance ownership; however, marital status and socioeconomic factors such as wealth and education as well as internet access and geographical location appeared to be the important predictors of non-use of health insurance. The associations differed by sex and urbanicity for certain variables. Addressing these inequities may help achieve universal coverage in health insurance ownership in the population.
CONCLUSIONS
More than one-quarter of the population in Jordan were not insured. Efforts to decrease disparities in insurance coverage should focus on minimising socioeconomic and geographical disparities to promote equity in terms of healthcare services.
目的
约旦约有三分之一的人口生活在贫困线以下，面临着重大的医疗保健、社会和国家发展问题。贫困人口的保险覆盖率低，自付支出高，这加剧了财政不安全状况，尤其是对边缘化人口而言。约旦政府旨在实现全民医疗保险覆盖，这是一项大胆的计划，需要研究证据来成功实施。在这项研究中，我们旨在评估任何医疗保险所覆盖的人口比例，以及拥有医疗保险的决定因素。
设计
基于人群的前瞻性队列研究。
地点
约旦。
方法
本研究的数据来自约旦人口和家庭健康调查，该调查由统计局于 2017 年 10 月初至 2018 年 1 月实施。样本特征以百分比和 95%置信区间表示。采用二元逻辑回归模型估计医疗保险拥有率的比值比。采用简约模型评估性别和地理差异。
结果
数据显示，2017-2018 年，12992 名男女中有 73.13%拥有医疗保险。医疗保险拥有情况没有表现出性别和年龄差异；然而，婚姻状况和社会经济因素（如财富和教育）以及互联网接入和地理位置似乎是未使用医疗保险的重要预测因素。这些关联因性别和城市性而有所不同。解决这些不平等问题可能有助于实现全民医疗保险的覆盖。
结论
约旦超过四分之一的人口没有保险。减少保险覆盖差距的努力应侧重于减少社会经济和地理差距，以促进医疗保健服务方面的公平。
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