英格兰的贫困分数和NHS实践支付趋势:2018-19年至2023-24年
Louis Steven Levene1, Christopher Newby2, George K Freeman3
1University of Leicester, Division of Public Health and Epidemiology, School of Medical Sciences, Leicester, United Kingdom lsl7@leicester.ac.uk.
概括
一般实践支付额度名义上上升,但实际上下降. 贫困对支付趋势产生了越来越少的积极影响,受地理位置和长期疾病流行影响.
科学领域:
- 卫生经济学 卫生经济学
- 资助初级保健的资金.
- 健康的社会经济决定因素
背景情况:
- 尽管调整了资本化公式,但贫困地区仍存在持续的资金短缺.
- 需要对与贫困有关的一般实践支付趋势进行最新分析.
研究的目的:
- 确定贫困分数是否预测了2018-19年至2023-24年期间的一般实践支付趋势.
- 分析多重贫困指数 (IMD) 和NHS实践支付之间的关系.
主要方法:
- 从2018-19年到2023-24年,对5,726个英语通用实践的多变量分析.
- 四位数混合效应模型与集群强度标准错误.
- 作为结果,每位患者的日志转换平均NHS支付,IMD得分和共变量作为固定效应.
主要成果:
- 平均支付额名义上增长了8.6%,但实际上下降了12.6% (CPI) 和9.0% (健康通货膨胀).
- 多重贫困指数 (IMD) 与支付趋势的关系是曲线的,达到IMD 49.8.8的峰值.
- 与非伦敦地区,农村地区,长期条件 (LTC) 和更高的基线支付相关的积极趋势;与更多的16岁以下,更大的列表和PMS合同相关的负面趋势.
结论:
- 贫困显示与支付趋势的积极关联正在减少,受地理位置和发病率所调节.
- 提高工资需要对通货膨胀,贫困,发病率和地理不平等进行调整.
- 资金公式需要修订,以更好地补偿社会经济因素并减少差异.
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