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目的:了解陕西省城市地区灾难性卫生支出发生率及不平等现状,探讨各影响因素对灾难性卫生支出不平等的贡献程度。方法:研究使用“家庭可支配收入”测量灾难性卫生支出发生率,运用集中指数测量灾难性卫生支出不平等程度,并将其进行分解分析。结果:陕西省城市地区灾难性卫生支出发生率为17.47%;灾难性卫生支出集中指数为-0.178。家庭经济状况、家庭规模、户主文化程度等对不平等的贡献率为正值,增加了偏富人不平等性。家庭经济状况对不平等的贡献率最大为39.37%。结论:陕西省城市地区灾难性卫生支出的发生主要集中于低收入家庭。缩小贫富差距,提供均等的受教育机会与增加小规模家庭抗风险能力对于降低灾难性卫生支出的不平等性具有重要的意义。
Objective: To understand the incidence and inequality of catastrophic health expenditures in urban areas of Shaanxi Province and to explore the contribution of various factors to the inequality of catastrophic health expenditures. METHODS: The study used the “household disposable income” to measure the incidence of catastrophic health expenditures, used the concentration index to measure the inequality of catastrophic health expenditures, and analyzed them in a disaggregated manner. Results: The incidence of disastrous health expenditure in urban areas of Shaanxi Province was 17.47%. The concentration index of disastrous health expenditure was -0.178. The positive contribution of the family economic status, family size and education level of head of household to inequalities has increased the inequality of the rich. The contribution rate of family economy to inequality is 39.37%. Conclusion: The disastrous health expenditures in urban areas of Shaanxi Province mainly focus on low-income families. Narrowing the gap between rich and poor, providing equal access to education and increasing the ability of small-scale families to resist risks are important for reducing inequality in catastrophic health spending.