Miller M K, Dixon B L, Fendley K
J Rural Health. 1986 Jul;2(2):17-36. doi: 10.1111/j.1748-0361.1986.tb00143.x.
For health planners to be able to use scarce resources efficiently and effectively to improve health, it is necessary for them to have reliable information on the productivity of the major categories of health producing expenditures. The present study utilizes a human capital perspective to evaluate the economic costs and benefits of medical manpower to communities in the West South Central United States. The results of the study suggest that beyond problems of maldistribution of physicians and nurses, the larger problem from an economic effectiveness perspective may be significant excesses of medical manpower, although some rural communities could justify, economically, adding physicians and/or nurses to reduce lost human capital. The findings indicate a need to further rationalize the allocation of health care resources as well as the need to consider means other than increased spending on curative medicine (e.g., health promotion and health education) as a strategy for efficiently meeting the objective of improving public health.
为了让卫生规划者能够高效且有效地利用稀缺资源来改善健康状况，他们有必要掌握有关主要类别卫生生产支出的生产率的可靠信息。本研究采用人力资本视角来评估美国西南中部地区医疗人力对社区造成的经济成本和效益。研究结果表明，除了医生和护士分布不均的问题外，从经济有效性角度来看，更大的问题可能是医疗人力严重过剩，不过一些农村社区在经济上有理由增加医生和/或护士以减少人力资本的损失。研究结果表明，需要进一步优化医疗资源的分配，同时也需要考虑除增加治疗性医疗支出（如健康促进和健康教育）以外的其他手段，以此作为有效实现改善公众健康目标的策略。
