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该文分析了阿根廷2001—2002年严重经济危机期间以及危机之前的卫生筹资和卫生服务利用的再分配效应情况。这段期间,有两点发生了显著的变化:即再分配效用变得更加积极以及服务利用从亲贫转向亲富。并且清楚地表明,当服务利用视筹资而定时,服务利用情况会发生迅速的变化;监测公平性时要结合筹资和服务利用情况综合考虑。从政策角度看,阿根廷卫生系统在经济低迷时很容易受到打击,其主要原因是阿根廷的健康保险高度依赖自费融资以及正式的雇佣关系。
This paper analyzes the redistribution of health financing and health service utilization in Argentina during the severe economic crisis of 2001-2002 and before the crisis. During this period, two significant changes have taken place: the redistribution of utility has become more positive and service utilization has shifted from pro-poor to pro-rich. It is also clear that service utilization changes rapidly as services are capitalized on a regular basis, and that equity and service utilization are integrated when monitoring equity. From a policy perspective, Argentina’s health system is vulnerable in times of economic downturn, mainly because health insurance in Argentina is highly dependent on self-financing and formal employment relations.