McDermott R A, Plant A J, Mooney G
Menzies School of Health Research, Alice Springs.
Aust N Z J Public Health. 1996 Dec;20(6):589-93. doi: 10.1111/j.1467-842x.1996.tb01071.x.
One of the stated aims of Australia's health care system is to achieve equity of access to health care according to need for all Australians, with the ultimate goal of moving toward statistical equality of good health for all. This paper examines how, using routinely collected population health data, we might answer the question of whether access to hospital care for Aborigines in the Northern Territory (NT) improved in relation to access for non-Aborigines during the period 1979 to 1988. Some of the advantages and shortfalls of this approach are discussed and an 'index of access' is postulated. This index is shown to be moving towards 1 during the period, suggesting that access to hospitals has improved for Aborigines compared with non-Aborigines, but that a substantial shortfall still exists. While this index can be useful for measuring progress toward achieving the horizontal equity of equal access for equal need, the more difficult task of defining and measuring progress toward vertical equity goals with respect to the persistent and gross inequalities in health status between Aboriginal and non-Aboriginal Australians deserves priority.
澳大利亚医疗保健系统既定目标之一是根据所有澳大利亚人的需求，实现获得医疗保健的公平性，最终目标是朝着全体澳大利亚人健康状况的统计平等迈进。本文探讨了如何利用常规收集的人口健康数据，来回答在1979年至1988年期间，北领地（NT）原住民获得医院护理的机会相对于非原住民而言是否有所改善这一问题。讨论了这种方法的一些优点和不足，并提出了一个“可及性指数”。结果表明，在此期间该指数正趋向于1，这表明与非原住民相比，原住民获得医院护理的机会有所改善，但仍存在很大差距。虽然该指数对于衡量在实现同等需求下平等可及性的横向公平方面取得的进展可能有用，但在界定和衡量在澳大利亚原住民与非原住民之间健康状况持续存在的严重不平等方面朝着纵向公平目标取得的进展这一更为艰巨的任务，应予以优先考虑。
