政府对初级医疗保健支出的决定因素:全球数据分析
Darius Erlangga1, Timothy Powell-Jackson2, Dina Balabanova2
1Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK Darius.Erlangga@lshtm.ac.uk.
BMJ global health
|November 30, 2023
概括
政府对初级医疗保健 (PHC) 的支出受到人均GDP和税收收入等经济因素的影响. 良好的治理,包括控制腐败和问责制,也显著影响PHC的资金水平.
科学领域:
- 全球卫生政策 全球卫生政策
- 卫生经济学 卫生经济学
- 公共管理 公共管理
背景情况:
- 正如阿斯塔纳宣言所强调的那样,初级卫生保健 (PHC) 对可持续的卫生系统至关重要.
- 尽管有政治承诺,PHC经常遭受资金不足,质量差以及缺乏问责制的困扰.
- 了解PHC支出驱动因素对于改善卫生系统绩效至关重要.
研究的目的:
- 分析102个国家的卫生保健政府支出的经济,社会和政治决定因素.
- 量化评估影响政府为PHC提供资金的因素,不包括自付费用.
- 为了确定人均和政府总支出的PHC的预测指标.
主要方法:
- 采用多变量回归分析来确定PHC支出的统计学上显著预测因素.
- 该研究的重点是政府对PHC的支出,作为承诺的关键指标.
- 分析了来自102个国家的数据,以检查各种决定因素与PHC资金之间的关系.
主要成果:
- 人均国内生产总值 (GDP),政府的卫生承诺和税收收入能力与人均卫生保健支出密切相关.
- 对腐败的控制与PHC的总支出有很强的关联.
- 发言权和问责制与政府对医疗保健的更大承诺有积极的联系,衡量为总卫生支出中的份额.
结论:
- 公共卫生和医疗保障的支出是由国家收入以外的因素驱动的,包括经济能力和治理质量.
- 提高医疗保健中心资金的有效策略必须考虑更广泛的治理安排和政治动态.
- 优先考虑医疗保健需要吸引各种各样的参与者,并认识到政治局面的限制,以改善卫生部门的决策.
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