发展中国家的公共卫生融资:跨国系统分析
Chunling Lu1, Matthew T Schneider, Paul Gubbins
1Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Lancet (London, England)
|April 13, 2010
概括
政府对卫生方面的支出在全球范围内增加,但对政府的卫生发展援助 (DAH) 减少了国内卫生支出. 然而,向非政府部门的DAH增加了国内卫生支出,凸显了需要谨慎的援助分配策略的需要.
科学领域:
- 全球健康 全球健康
- 卫生经济学 卫生经济学
- 公共卫生政策 公共卫生政策
背景情况:
- 政府对卫生方面的支出是国家承诺和计划可持续性的关键指标.
- 对发展中国家政府卫生支出的分析对于了解卫生融资趋势至关重要.
- 影响公共卫生融资的因素包括GDP,政府规模,艾滋病毒流行率,减免债务和卫生发展援助 (DAH).
研究的目的:
- 系统地分析发展中国家政府卫生支出数据来源.
- 描述来自国内来源的公共卫生融资趋势.
- 评估国内卫生支出与GDP,政府规模,艾滋病毒流行率,减免债务和DAH之间的关系.
主要方法:
- 使用多种数据来源,系统地分析政府在卫生方面的支出作为代理人 (GHE-A).
- 来源的质量评估和完整的GHE-A数据的多重归算.
- 面板回归方法用于估计国内卫生支出与主要经济和卫生指标之间的关联.
主要成果:
- 从1995年至2006年,来自国内来源的公共卫生融资在全球范围内几乎翻了一番.
- 虽然国内卫生支出整体上升,但一些撒哈拉以南非洲国家在卫生支出份额下降.
- 针对政府的卫生发展援助 (DAH) 对国内卫生支出产生了负面影响,而对非政府部门的DAH则产生了积极影响.
结论:
- 建议包括对医疗支出进行标准化的监测,以及对医疗支出份额的协作目标.
- 投资于发展中国家管理DAH的能力至关重要.
- 应仔细评估DAH对非政府部门的影响,并考虑全球价格补贴等替代援助机制.
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