取消医疗保健用户费用对谁有利?来自加纳随机实验的证据

T. Powell-Jackson, K. Hanson, C. Whitty, E. Ansah
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引用次数: 4

摘要

在发展中国家,取消医疗保健使用费能在多大程度上改善人口健康,部分取决于具有不同健康需求的个人的行为反应有何不同。使用来自加纳免费医疗随机实验的数据和客观且基础广泛的基线健康测量,我们检查了对最初患病和健康儿童的不同影响。我们发现,免费保健改善了儿童的求医行为,降低了自付费用,减少了基线时患病儿童的贫血,但对最初健康的儿童没有影响。虽然对总体干预人口没有健康影响,但有证据表明,取消用户费用可能使最需要保健的个人能够接受初级保健,从而改善他们的健康。没有迹象表明免费护理鼓励了对服务的轻率使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Who Benefits from Removing User Fees for Health Care? Evidence from a Randomised Experiment in Ghana
The extent to which removing user fees for health care in developing countries improves population health rests, in part, on how behavioural responses vary across individuals with different health needs. Using data from a randomised experiment of free care in Ghana and a measure of baseline health that is both objective and broad-based, we examined differential effects for initially ill and healthy children. We find that free care improved health seeking behaviour, lowered out-of-pocket spending and reduced anaemia amongst children who were ill at baseline but had no effect on initially healthy children. Whilst there was no health effect on the intervention population taken overall, the evidence suggests that removing user fees may have enabled individuals with the greatest health need to take up primary health care, thereby improving their health. There was no indication that free care encouraged frivolous use of services.
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