权力转移对经历过的健康和幸福感的影响
Yao Wei1, Laura Anselmi1, Luke Munford1
1Health Organisation, Policy and Economics, School of Health Sciences, University of Manchester, United Kingdom.
Social science & medicine (1982)
|August 14, 2023
概括
大曼彻斯特的医疗系统权力下放并没有显著改善居民的健康和福祉. 有效的人口健康管理需要地方问责制和预算控制.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 卫生政策 卫生政策
背景情况:
- 将卫生系统转移到地方一级是全球政策趋势.
- 目标是通过解决特定的当地需求来提高人口健康.
- 2016年,大曼彻斯特发生了协调的公共服务权力下放.
研究的目的:
- 评估卫生系统权力转移对体验健康和福祉的影响.
- 评估2016年后大曼彻斯特分权的有效性.
- 确定影响当地卫生管理成功的因素.
主要方法:
- 利用了来自英国家庭纵向调查 (2012-2020) 的13938名成年受访者的数据.
- 使用差异差异和滞后依赖变量的回归分析.
- 比较大曼彻斯特与英格兰其他地区的结果.
主要成果:
- 在大曼彻斯特,没有观察到体验到的健康和幸福感的统计学意义上的变化.
- 分权化后的四年期间没有显示出可测量的改善.
- 该研究没有发现权力转移与短期改善健康结果之间的直接联系.
结论:
- 在没有预算权力和问责制的情况下,委托人口健康管理可能是无效的.
- 地方卫生系统改革需要全面的权力来实现有形改善.
- 从这种权力转移模型来看,对体验到的健康和福祉的短期影响并不明显.
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