Department of Health Care Management, Faculty of Economics & Management, Technische Universität Berlin, Germany. Straße des 17. Juni 135 10623 Berlin, Germany; Myers-JDC-Brookdale Institute, Jerusalem, Israel.
Institute of Health Policy, Management and Evaluation, University of Toronto, Canada. 155 College Street, Toronto M5T 3M6, Ontario, Canada.
Health Policy. 2024 May;143:105058. doi: 10.1016/j.healthpol.2024.105058. Epub 2024 Mar 26.
Progressive financing of health care can help advance the equity and financial protection goals of health systems. All countries' health systems are financed in part through private mechanisms, including out-of-pocket payments and voluntary health insurance. Yet little is known about how these financing schemes are structured, and the extent to which policies in place mitigate regressivity. This study identifies the potential policies to mitigate regressivity in private financing, builds two qualitative tools to comparatively assess regressivity of these two sources of revenue, and applies this tool to a selection of 29 high-income countries. It provides new evidence on the variations in policy approaches taken, and resultant regressivity, of private mechanisms of financing health care. These results inform a comprehensive assessment of progressivity of health systems financing, considering all revenue streams, that appears in this special section of the journal.
标题：渐进式医疗融资助力实现卫生系统公平性和财务保障目标
摘要：本研究旨在确定减轻私人融资中逆向选择问题的潜在政策，构建了两个定性工具，以比较评估这两种收入来源的逆向选择程度，并将该工具应用于 29 个高收入国家。研究结果表明，各国在采取减轻私人融资中逆向选择问题的政策措施方面存在差异，且这些政策措施的实施结果也导致了卫生保健私人融资机制的逆向选择程度存在差异。这些结果为考虑所有收入来源的卫生系统筹资累进性的综合评估提供了信息，该评估结果发表在本杂志的特刊中。
