公共支出是否反映了对健康的需求:印度地区一级的横截面分析
Shankar Prinja1, Atul Sharma2, Aarti Goyal3
1Professor of Health Economics, Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
通过国家卫生使命 (NHM) 的公共卫生支出在婴儿死亡率较高的地区更高. 国家卫生融资 (SHF) 与婴儿死亡率呈反向关系,强调需要公平的资源分配.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 卫生政策 卫生政策
背景情况:
- 关于公共医疗收入分配与健康指标之间的联系的证据是不一致的.
- 了解资源分配对健康结果的影响对于有效的政策至关重要.
研究的目的:
- 调查国家卫生融资 (SHF) 和中央政府拨款 (国家卫生使命 - NHM) 与婴儿死亡率之间的关联.
- 分析公共卫生支出与婴儿死亡率 (IMR) 在地区一级之间的关系.
主要方法:
- 婴儿死亡率 (IMR) 数据来源于国家家庭健康调查-4.
- 2015-16年国家级卫生预算数据,用于SHF和NHM.
- 使用具有身份链接函数的通用线性模型进行多变量分析.
主要成果:
- 人均SHF分配明显超过NHM的人均支出.
- 拥有较高SHF分配的地区表现出较低的IMR,尽管在统计学上并不显著.
- 在IMR较高的地区,NHM分配显著更高,表明资源分配的潜在差异.
- 人均净国内生产和女性识字率的增加与IMR的下降相关.
- 较高的5岁以下腹发病率与IMR增加有关.
结论:
- 国家卫生使命 (NHM) 改善了医疗保健融资的垂直公平.
- 各国必须在卫生资源分配方面提高对地区特定需求的响应能力.
- 优先考虑对健康的社会决定因素的支出对于实现全民健康覆盖是必不可少的.
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