共查询到17条相似文献,搜索用时 140 毫秒
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目的:分析广西壮族自治区农村各种卫生筹资渠道的公平程度。方法:利用比例法、累进性分析等方法分析2000~2008年广西农村各种卫生筹资渠道的公平性。结果:2000~2008年广西农村通过税收进行筹资的公平性呈上升趋势,2008年略显累进性(kakwani指数为0.0076)。直接现金卫生支出的kakwani指数在-0.1上下波动,筹资的公平性较差。结论:提高政府卫生投入力度,加强利用税收进行卫生筹资,拓宽社会卫生筹资,降低个人卫生支出的比例,从而提高卫生筹资的公平性。 相似文献
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目的研究广西城镇居民各种卫生筹资渠道的公平程度。方法利用比例法、累进性分析(集中曲线、kakwani指数)等方法分析广西城镇居民各种卫生筹资渠道的公平性。结果广西卫生总费用中个人卫生支出的比例过高。2000~2008年广西城镇居民现金卫生支出筹资的公平性优于通过税收筹资的公平性。税收和现金卫生支出的kakwani指数均为负值,表现为累退性,卫生筹资的公平性较差。结论政府应加大卫生投入,拓展社会筹资渠道,降低个人卫生支出的比例。加强利用税收进行卫生筹资,从而提高卫生筹资的公平性。 相似文献
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国际现有的卫生筹资公平性评价方法主要有:家庭卫生筹资贡献率的计算、对卫生筹资渠道累进性的分析、个人现金卫生支出致贫影响分析等。文章通过对这几种方法的分析进而讨论我国卫生筹资公平性研究方法的现状。 相似文献
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目的:对新疆生产建设兵团全省、城市和农场卫生筹资公平性进行分析,测量各种卫生筹资渠道的累进性,反映卫生支出在不同社会经济群体之间的分布与公平程度。方法:利用兵团2004年第二次卫生服务调查数据,运用比例法和指数法对兵团家庭卫生筹资累进性进行分析。结果:从绝对分布看,兵团各种卫生支出的集中指数均为正,富裕家庭支付的多,贫困家庭支付的少;从相对分布看,税收支出的Kakwani指数为负,筹资分布表现为累退,社会医疗保险支出、商业健康保险支出和现金卫生支出的Kakwani指数均为正,筹资分布呈现出累进的特点。从兵团城市和农场各种卫生支出的绝对分布看,均是富裕家庭支付的多,贫困家庭支付的少;从相对分布看,城市和农场卫生筹资特点不完全相同。结论:新疆兵团卫生筹资的绝对分布是公平的;相对分布除社会医疗保险和个人现金卫生支出筹资机制表现出公平特点外,税收筹资表现出不公平性特点,商业健康保险卫生筹资是否公平不能判断,因为分城市和农场其表现出来的特征不同;4种卫生筹资机制公平性相比较,社会医疗保险支出的公平性最好,税收支出公平性最差。 相似文献
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卫生筹资公平性及其影响因素分析:以陕西省B市为例 总被引:1,自引:0,他引:1
目的:评价B市卫生筹资总体公平性程度,比较不同筹资方式的公平性,探寻影响家庭发生灾难性支出的主要因素.方法:卫生筹资公平性指数法、卫生筹资累进性分析方法、家庭灾难性卫生支出及Logistic回归分析.结果:(1)B市中低收入家庭组的总体公平性程度较差. (2)税收、社会保险、现金支付方式3种卫生筹资方式都表现出累进性. (3)家庭老龄人口数、家庭收入、家庭支出以及现金卫生支出是影响家庭灾难性支出发生与否的主要因素.结论:(1)扩大社会医疗保险覆盖面、为灾难性支出家庭设立专项医疗救助基金. (2)加强政府在卫生筹资中的主导作用,拓宽卫生筹资渠道. 相似文献
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Progressivity, horizontal equity and reranking in health care finance: a decomposition analysis for The Netherlands 总被引:2,自引:0,他引:2
This paper employs the method of Aronson et al. (1994) to decompose the redistributive effect of the Dutch health care financing system into three components: a progressivity component, a classical horizontal equity component and a reranking component. Results are presented for the health care financing system as a whole, as well as for its constituent parts. A final section sets out to uncover the relative importance (in terms of their effects on progressivity, horizontal equity and reranking) of the key institutional features of one component of the Dutch system-the AWBZ social insurance scheme. 相似文献
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Klavus J 《Journal of health economics》2001,20(3):363-377
This paper employs a distribution-free statistical test suitable for comparisons based on dependent samples to analyse changes in health care financing distributions on Finnish data. In distinction to the more general summary index approach used in most studies of progressivity measurement, the difference between the Lorenz curve of income inequality and the concentration curves of various taxes and payments is used to evaluate progressivity dominance and changes in progressivity. Sample weights are applied to account for the effect of sampling design and non-response. The analysis demonstrates that the dominance approach can be successfully applied to various types of distributional problems besides comparisons concerning differences in income distributions. As an empirical application the paper presents estimation results for the progressivity of various health care financing sources using data from the 1987 and 1996 Finnish Health Care Surveys. 相似文献
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This research study examines the impact of the level of state tax code progressivity on selected children's health outcomes. Specifically, it examines the degree to which a state's tax code ranking along the progressive-regressive continuum relates to percentage of low birthweight babies, infant and child mortality rates, and percentage of uninsured children. Using data merged from a number of public data sets, the authors find that the level of state tax code progressivity is a factor in state rates of infant and child mortality. States with lower median incomes and regressive tax policies have the highest rates of infant and child mortality.With regard to the percentage of children 17 years of age and below who lack health insurance, it is found that larger states with regressive tax policies have the largest percentage of uninsured children. In general, more heavily populated states with more progressive tax codes have healthier children. The implications of these findings are discussed in terms of tax policy and the well-being of children as well as for social work education, social work practice, and social work research. 相似文献
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A Wagstaff E van Doorslaer H van der Burg S Calonge T Christiansen G Citoni U G Gerdtham M Gerfin L Gross U H?kinnen P Johnson J John J Klavus C Lachaud J Lauritsen R Leu B Nolan E Perán J Pereira C Propper F Puffer L Rochaix M Rodríguez M Schellhorn O Winkelhake 《Journal of health economics》1999,18(3):263-290
This paper presents further international comparisons of progressivity of health care financing systems. The paper builds on the work of Wagstaff et al. [Wagstaff, A., van Doorslaer E., et al., 1992. Equity in the finance of health care: some international comparisons, Journal of Health Economics 11, pp. 361-387] but extends it in a number of directions: we modify the methodology used there and achieve a higher degree of cross-country comparability in variable definitions; we update and extend the cross-section of countries; and we present evidence on trends in financing mixes and progressivity. 相似文献
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We study the impact of endogenous longevity on optimal tax progressivity and inequality in an overlapping generations model with skill heterogeneity. Higher tax progressivity decreases both the longevity gap and net income inequality, but at the expense of lower average lifetime and income. We find that the welfare-maximizing income tax is less progressive in our model with endogenous longevity than in our model with exogenous longevity. In a highly stylized calibration of the US economy, we show that optimal tax progressivity is less than what prevails under the current US tax system. Our results are robust to the range of empirical labor supply elasticity and the assumptions of missing annuity markets and stochastic health. Our conclusion for the optimal progressivity of the US tax system can be altered by the adoption of a more egalitarian welfare function or by increases in prevailing levels of wage inequality. 相似文献
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Regional differences in health care delivery: implications for a national resource allocation formula 总被引:1,自引:0,他引:1
In several countries formulae for allocating resources to regions are derived using national average relationships between population characteristics and health service use. However, there may be significant regional heterogeneity in health care delivery which, has two main implications for a national resource allocation formula. First, it offers alternative ways of measuring the relative needs of different population groups. Since the primary focus of research and policy is on the difficulty of targeting resources at high-need populations, it is proposed that progressivity in the delivery of health care could be seen as a frontier problem analogous to efficiency. The effects of using the slope parameters from the most progressive region are simulated. Second, regional heterogeneity may thwart the objective of the formula of securing equitable use of resources by different population groups. An adjustment mechanism is developed to illustrate the trade-off between the levels of geographical and vertical equity achieved. A locus of equity possibilities for acute care in Scotland is derived. Traditional formulae represent a corner solution indicating extreme relative aversion to geographical inequity. Because regional variation in need dominates regional variation in progressivity in Scotland, high-need rather than progressive regions gain from the pursuit of vertical equity. 相似文献
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Ugá MA Santos IS 《Cadernos de saúde pública / Ministério da Saúde, Funda??o Oswaldo Cruz, Escola Nacional de Saúde Pública》2006,22(8):1597-1609
This article analyzes the level of progressivity in taxes financing the Brazilian Unified National Health System (SUS). Distribution of the tax burden financing the SUS was calculated using micro-data from the Household Budgets Survey, 2002-2003. The Kakwani index, which shows a tax system's level of progressivity, was calculated. The Kakwani index of public financing was -0.008, and SUS financing was nearly proportional to income. From a social justice perspective this is highly undesirable in a society like Brazil, with a Gini index of 0.57. The system should be clearly progressive in order to counterbalance the country's extreme income concentration. 相似文献