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Equity in health care financing in Palestine: the value-added of the disaggregate approach.

机译：巴勒斯坦卫生保健筹资中的公平：分类方法的增值。

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摘要

This paper analyzes the redistributive effect and progressivity associated with the current health care financing schemes in the Occupied Palestinian Territory, using data from the first Palestinian Household Health Expenditure Survey conducted in 2004. The paper goes beyond the commonly used "aggregate summary index approach" to apply a more detailed "disaggregate approach". Such an approach is borrowed from the general economic literature on taxation, and examines redistributive and vertical effects over specific parts of the income distribution, using the dominance criterion. In addition, the paper employs a bootstrap method to test for the statistical significance of the inequality measures. While both the aggregate and disaggregate approaches confirm the pro-rich and regressive character of out-of-pocket payments, the aggregate approach does not ascertain the potential progressive feature of any of the available insurance schemes. The disaggregate approach, however, significantly reveals a progressive aspect, for over half of the population, of the government health insurance scheme, and demonstrates that the regressivity of the out-of-pocket payments is most pronounced among the worst-off classes of the population. Recommendations are advanced to improve the performance of the government insurance schemes to enhance its capacity in limiting inequalities in health care financing in the Occupied Palestinian Territory.
机译：本文使用2004年进行的首次巴勒斯坦家庭医疗保健支出调查的数据，分析了与巴勒斯坦被占领土内当前医疗保健筹资计划相关的再分配效应和累进性。本文超越了通常使用的“汇总汇总指数法”应用更详细的“分解方法”。这种方法是从一般的税收经济学文献中借来的，并使用支配地位标准检验了收入分配特定部分的再分配和垂直效应。此外，本文采用自举法来检验不平等测度的统计显着性。虽然汇总和分类方法都确认了自付费用的富裕和回归特征，但汇总方法并不能确定任何可用保险计划的潜在累进特征。但是，这种分类方法显着地揭示了政府医疗保险计划对超过一半的人口而言是一个进步方面，并表明自付费用的回归性在最差的此类人群中最为明显。人口。提出了改善政府保险计划绩效的建议，以增强其限制巴勒斯坦被占领土医疗保健筹资不平等的能力。

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