Health, Nutrition, and Population Unit, The World Bank, Washington, DC, USA.
Health Syst Reform. 2021 Jul 1;7(2):e1911067. doi: 10.1080/23288604.2021.1911067.
Universal Health Coverage is one of the key targets of the Sustainable Development Goals and it implies that everyone can access the healthcare they need without suffering financial hardship. In this paper, we use a large set of household surveys to examine if older populations are facing different degrees of financial hardship compared to younger populations. We find that while differences in average age structures between countries are not systematically associated with higher financial risk related to out-of-pocket health expenditures, there are large differences in financial hardship between younger and older households within countries. Households with more elderly members are more likely to face catastrophic and impoverishing out-of-pocket health payments compared to younger households, and this age gradient is stronger for the poorest segments of the population. Making progress toward Universal Health Coverage will require extension and improved targeting of benefit packages and financial protection to meet the health needs of older adults, and especially the poorest and most vulnerable segments of elderly populations.
全民健康覆盖是可持续发展目标的关键指标之一,它意味着每个人都可以获得所需的医疗保健,而不会陷入经济困境。本文利用大量家庭调查数据,考察了老年人口与年轻人口相比是否面临不同程度的经济困难。我们发现,虽然各国平均年龄结构的差异与自付医疗支出相关的财务风险增加并无系统关联,但各国国内年轻家庭和老年家庭之间的经济困难存在很大差异。与年轻家庭相比,有更多老年人的家庭更有可能面临灾难性和贫困性的自付医疗支出,而对于最贫困的人口群体来说,这种年龄梯度更为明显。要实现全民健康覆盖,就需要扩大和改进福利计划的覆盖范围,并提供财务保护,以满足老年人的健康需求,特别是最贫困和最脆弱的老年人群体。