"同一枚硬币的两个面"? 一项纵向分析,评估财政紧缩政策是否加速了英格兰NHS私有化2013-2020年
Benjamin Goodair1, Anders Malthe Bach-Mortensen1,2, Aaron Reeves1
1Department of Social Policy and Intervention, University of Oxford, Oxford, UK.
BMJ public health
|February 28, 2025
概括
国民健康服务 (NHS) 的私有化并非直接受到紧缩政策的驱动. 与外包相关的健康状况恶化是与紧缩政策对公共健康的负面影响分开的一个问题.
科学领域:
- 卫生政策分析 卫生政策分析
- 公共卫生研究 公共卫生研究
- 卫生经济学 卫生经济学
背景情况:
- 英国政府在2008年金融危机之后实施了紧缩措施,影响了包括国家卫生服务 (NHS) 在内的公共服务.
- "2012年卫生和社会护理法"鼓励NHS专员从事以营利为目的的外包,这导致了不同程度的私营部门参与.
研究的目的:
- 调查NHS紧缩削减和医疗保健服务日益私有化之间的关系.
- 确定本地资金变化是否影响了临床委托组 (CCG) 进行营利外包的程度.
主要方法:
- 在2013年至2020年期间,对来自英格兰170个CCG的数据进行了纵向分析.
- 计算紧缩政策的影响并评估其与利外包率的相关性.
主要成果:
- 紧缩措施给CCG带来了巨大的财务压力,在2014年至2021年期间,平均实时债务增加了212万英.
- 人均NHS资金下降对以营利为目的的外包率产生了极小且在统计学上不显著的影响.
- 地方公共支出变化并没有混营利外包与可治疗死亡率之间的关系.
结论:
- 当地的NHS私有化似乎不是紧缩政策的直接后果.
- 与私有化相关的负面健康结果需要与紧缩政策对公共健康的不利影响分开考虑.
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