评估卫生系统在实现全民医疗覆盖方面的效率:数据包裹分析
Paul Eze1, Chidumebi Judith Idemili2, Lucky Osaheni Lawani2
1Penn State University, University Park, PA, USA.
概括
大多数国家在利用卫生资源实现全民健康覆盖 (UHC) 方面效率低下. 提高卫生系统效率,重点关注初级卫生保健 (PHC) 和治理,可以促进全球的UHC进展.
科学领域:
- 卫生系统研究 卫生系统研究
- 全球卫生政策 全球卫生政策
- 卫生经济学 卫生经济学
背景情况:
- 全民健康覆盖 (UHC) 是一个全球优先事项,旨在实现平等获得医疗服务和金融保护.
- 评估卫生系统的技术效率对于优化对UHC目标的资源配置至关重要.
- 之前的估计表明,各国的UHC成就水平各不相同.
研究的目的:
- 估计191个国家的卫生系统在实现UHC方面的技术效率.
- 确定影响卫生系统效率的社会经济和环境因素.
- 量化通过提高效率可以实现的潜在的UHC改进.
主要方法:
- 使用面向输出的数据包裹分析 (DEA) 来评估技术效率.
- 全民健康保险指数 (服务覆盖和金融保护) 是输出,人均医疗支出,医疗保健劳动力和医院病床作为输入.
- 使用托比特回归与引导分析来检查影响因素.
主要成果:
- 全球UHC指数的平均值为76.9,在国家层面有显著的差异 (48.4至94.8).
- 绝大多数国家 (78.5%) 在UHC的资源利用方面表现出技术效率低下.
- 提高效率可以使UHC指数在使用当前资源的收入水平上增加4.1%6.8%.
结论:
- 卫生系统在实现UHC方面的低效率在所有收入水平和世卫组织地区普遍存在.
- 在初级医疗保健 (PHC) 中进行战略投资,改善治理和UHC立法是提高效率的关键驱动力.
- 通过提高效率来优化资源使用提供了一个可行的途径,以加速全球的UHC进展.
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