4.6 Article

National Health Spending, Health-Care Resources, Service Utilization, and Health Outcomes

期刊

AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 191, 期 3, 页码 386-396

出版社

OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kwab179

关键词

health-care resources; health service utilization; health spending; mortality; out-of-pocket spending

资金

  1. Japan Society for the Promotion of Science [20J00394]
  2. Murata Science Foundation
  3. Grants-in-Aid for Scientific Research [20J00394] Funding Source: KAKEN

向作者/读者索取更多资源

Cross-national studies have found limited evidence of benefits in the linkage between health-care spending and population health. This study suggests that variation in health spending is not associated with decreased mortality rates and has a weak association with increased health-care resources and service utilization. In contrast, gross domestic product per capita is significantly associated with increased health resources, higher service utilization, and lower mortality rates.
Cross-national studies of the linkage of health-care spending with population health have found surprisingly limited evidence of benefits. In this study, we investigated associations between national health spending and key health resources (numbers of hospital beds, physicians, and nurses) and utilization of cost-effective health services (antenatal care, attendance of trained staff at childbirth, and measles vaccination), sometimes in ways that curtail the benefits of that expenditure. Using annual panel data from 1990-2014 covering 140 countries, we show that variation in health spending as a share of gross domestic product is not associated with decreased mortality rates. It is also very weakly associated with increased health-care resources and health service utilization (elasticity smaller than 0.08), with the association being close to 0 in low-income countries. In addition, countries with a higher share of out-of-pocket spending have a significantly lower level of health resources and service utilization. These findings, rather than the ineffectiveness of health care, could explain the lack of impact of health spending. In contrast, gross domestic product per capita is significantly associated with increased health resources, a higher rate of service utilization, and lower mortality rates, suggesting that income is an important determinant of public health.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.6
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据