衡量卫生系统的弹性:了解过度死亡率和卫生系统绩效之间的关系
Irene Papanicolas1, Jorge Ledesma2
1Department of Health Services, Policy and Practice, Brown School of Public Health, Providence, RI, USA.
在COVID-19之前,更强大的卫生系统通常表现出更好的性,死亡率较低. 标准化基线表现可以提高评估国家对卫生危机的抵御能力的准确性.
科学领域:
- 全球健康 全球健康
- 卫生系统研究 卫生系统研究
- 流行病学 流行病学
背景情况:
- 随着COVID-19的爆发,人们越来越需要有弹性的卫生系统来应对大规模的健康危机.
- 卫生系统弹性和绩效之间的关系还不太清楚,人们对它们之间的联系有不同的看法.
- 过度死亡率,虽然用于衡量性,但可能会受到大流行前条件和基线死亡率的影响.
研究的目的:
- 调查COVID-19大流行期间疫情前卫生系统绩效和弹性之间的联系.
- 通过使用大流行前两年的过度死亡率数据来评估性.
- 探索基线表现如何影响卫生系统抵御健康危机的能力.
主要方法:
- 利用医疗保健获取和质量指数 (HAQ) 来评估194个国家的基线卫生系统绩效.
- 将大流行前的HAQ指数得分与来自多个来源的年龄标准化过度死亡率数据进行比较.
- 雇佣了大流行前绩效的正常化值,以提高过度死亡率的跨国可比性.
主要成果:
- 疫情前HAQ指数得分较高的国家在COVID-19大流行期间通常表现出较低的过度死亡率.
- 基线表现和过度死亡率之间的关联在流行病的第二年是最一致的.
- 通过使用正常化值调整基线表现,提高了跨国过度死亡率的可比性.
结论:
- 疫情前更高的卫生系统绩效似乎与对卫生危机的更强性有关.
- 标准化基线绩效指标可以导致更准确的跨国弹性评估.
- 调查结果表明,投资加强卫生系统可能会增强疫情防控和应对能力.
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