新疆农村家庭2003～2008年卫生筹资公平性变化分析

目的]研究2003～2008年新疆农村不同经济水平家庭卫生筹资的公平性变化。方法]利用新疆2003、2008年国家卫生服务调查相关数据,运用比例法和指数法测算农村不同经济水平家庭各项卫生筹资渠道的公平性。结果]2003、2008年税收支出的集中指数分别为0.33、0.36,Kakwani指数分别为-0.05、-0.02筹资趋向等比例;社会医疗保险支出集中指数分别为-0.33、0.15,Kakwani指数分别为-0.71、-0.23;商业健康保险支出集中指数分别为0.64、0.58,Kakwani指数分别为0.25、0.20;现金卫生支出集中指数分别为0.43、0.50,Kakwani指数分别为0.04、0.12。结论]税收卫生筹资公平性变化不大,相对可支付能力而言筹资均趋向等比例,新农合改善了农村居民社会医疗保障筹资的绝对公平性,贫困家庭支付商业健康保险增多,现金卫生支出向富裕家庭倾斜程度加大。

ANALYSIS OF THE EQUITY OF RURAL FAMILY HEALTH FINANCING IN XINJIANG PROVINCE FROM 2003 TO 2008

Objective]To study the equity of rural health finance equity among different economic level families in Xinjiang province.Methods]Linking with national health services survey data of Xinjiang province in 2003 and 2008,proportion and index methods was measured the equity of every health finance resource among different economic level families in rural areas.Results]In 2003 and 2008,the concentration indexes(CI)of tax expenditure were 0.33 and 0.15,and Kakwani indexes were-0.05 and-0.02,indicating tax financing tended to equal proportion.The CI of social health security expenditure were-0.33 and 0.15,and Kakwani indexes were-0.71,-0.23.The CI of commercial health insurance expenditure were 0.64 and 0.58,and Kakwani indexes were 0.25,0.20.The CI of out-of-pocket were 0.43 and 0.50,and Kakwani indexes were 0.04 and 0.12.Conclusion]The health finance by tax changed little,relative to their ability to payment were all proportion,the NCMS improved the equity of social health security expenditure in rural areas,the poor families paid for commercial health insurance increased,and out-of-pocket leaned to wealthy families increased.