重新审视健康方面的财务保护:针对服务或疾病的分析是否低估了灾难性医疗支出?

IF 2 3区 医学 Q2 ECONOMICS
Health economics Pub Date : 2024-02-20 DOI:10.1002/hec.4813
John E. Ataguba, Hyacinth E. Ichoku, Marie-Gloriose Ingabire, James Akazili
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引用次数: 0

摘要

经济学家最初开发了使用自付医疗支出总额或总支出来评估财务灾难的方法。当总的自付医疗支出超过一个家庭在特定时期内总收入或总支出的固定比例(即阈值)时,总的自付医疗支出就是财务灾难性的。然而,现在这些方法被用于评估特定疾病或服务的财务灾难,而不是总的自付医疗支出,而不使用特定疾病或服务的阈值。本文认为,不使用疾病或服务特定阈值进行此类评估会产生误导,低估了财务灾难的负担,尤其是在贫困家庭中。本文随后提出了针对特定疾病或服务的灾难性付款阈值,并将其应用于尼日利亚,结果发现,在所考虑的五个服务组中,财务灾难被低估了。论文强调了使用针对特定疾病或服务的阈值以及避免使用未经调整的阈值的重要性,因为未经调整的阈值可能会使较贫困家庭得不到经济保护。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Financial protection in health revisited: Is catastrophic health spending underestimated for service- or disease-specific analysis?

Financial protection in health revisited: Is catastrophic health spending underestimated for service- or disease-specific analysis?

Economists originally developed methods to assess financial catastrophe using total or aggregate out-of-pocket health spending. Aggregate out-of-pocket health spending is financially catastrophic when it exceeds a fixed proportion (i.e., threshold) of a household's total income or expenditure in a given period. However, these methods are now applied to assess financial catastrophe in disease- or service-specific rather than aggregate out-of-pocket health spending without using disease- or service-specific thresholds. This paper argues that not using disease- or service-specific thresholds for such assessments is misleading and underestimates the burden of financial catastrophe, especially among households from poorer backgrounds. It then proposed disease- or service-specific catastrophic payment thresholds, applied them to Nigeria and found that financial catastrophe was underestimated for the five service groups considered. The paper stresses the importance of using disease- or service-specific thresholds and avoiding unadjusted thresholds, which may leave poorer households behind as financially protected.

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来源期刊
Health economics
Health economics 医学-卫生保健
CiteScore
3.60
自引率
4.80%
发文量
177
审稿时长
4-8 weeks
期刊介绍: This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems. Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses. Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.
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