浙江省政府医疗机构补助的受益归属分析

目的:测算浙江省政府医疗机构补助在不同经济群体间的分布,评价政府医疗机构补助分布的公平程度。方法:利用浙江省2003年家庭卫生服务调查等数据,运用受益归属分析(BIA Benefit Incidence Analysis)方法来评价浙江省政府医疗机构补助分布的公平性和目标效率。结果:从绝对公平角度,无论门诊补助、住院补助还是总补助都是贫困人群获得的少,而富裕人群获得的多,各种补助分布的绝对公平性均较差;从相对公平角度,门诊补助分布的相对公平性较好,而住院补助分布的相对公平性较差。结论:浙江省政府医疗机构补助效果与理想的目标还有一定的距离,补助的主要受益者不是穷人而是富人,补助的绝对公平程度较差。为提高卫生领域政府医疗机构补助的公平性,应进一步改善政府补助的方式,转移政府补助的重点以及提高人群特别是贫困人群的卫生服务的可及性等。

Benefit Incidence Analysis of Government Medical Institution Reimbursement in Zhejiang Province

Objectives Through calculating the distribution of government medical institution reimbursement in Zhejiang province among different economic groups,to evaluate the equity of distribution of government medical institution reimbursement.Methods With benefit incidence analysis(BIA) method,we analyzed the data from 2003 family health service survey in Zhejiang province to evaluate the equity and efficiency of government medical institution reimbursement in Zhejiang province.Results From the angle of absolute equity,for outpatient reimbursement,inpatient reimbursement and total reimbursement,the poor benefit from them little and the rich benefit much.From the angle of relative equity,the relative equity of distribution of outpatient reimbursement was better and outpatient reimbursement was poorer.Conclusions There is a gap between the effect and the goal of government medical institution reimbursement in Zhejiang province.The main beneficiary is not the poor but the rich.The absolute equity of reimbursement is poor.To improve the equity of government medical institution reimbursement in health field,it should improve the way of reimbursement,transfer the key of government reimbursement,and advance the accessibility of health service for population,especially for the poor.