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获得初级卫生保健与健康结果:全科医生特征与死亡率之间的关系。

Access to primary health care and health outcomes: the relationships between GP characteristics and mortality rates.

作者信息

Aakvik Arild, Holmås Tor Helge

机构信息

Department of Economics, University of Bergen, Herman Fossg. 6, N-5007 Bergen, Norway.

出版信息

J Health Econ. 2006 Nov;25(6):1139-53. doi: 10.1016/j.jhealeco.2006.04.001. Epub 2006 May 3.

Abstract

This paper analyses the impact of economic conditions and access to primary health care on health outcomes in Norway. Total mortality rates, grouped into four causes of death, were used as proxies for health, and the number of general practitioners (GPs) at the municipality level was used as the proxy for access to primary health care. Dynamic panel data models that allow for time persistence in mortality rates, incorporate municipal fixed effects, and treat both the number and types of GPs in a district as endogenous were estimated using municipality data from 1986 to 2001. We reject the significant relationship between mortality and the number of GPs per capita found in most previous studies. However, there is a significant effect of the composition of GPs, where an increase in the number of contracted GPs reduces mortality rates when compared with GPs employed directly by the municipality.

摘要

本文分析了经济状况和获得初级卫生保健的机会对挪威健康结果的影响。按四种死因分组的总死亡率被用作健康的代理指标,市政一级的全科医生数量被用作获得初级卫生保健机会的代理指标。利用1986年至2001年的市政数据,估计了动态面板数据模型,该模型考虑了死亡率的时间持续性,纳入了市政固定效应,并将一个地区全科医生的数量和类型都视为内生变量。我们拒绝了大多数先前研究中发现的死亡率与人均全科医生数量之间的显著关系。然而,全科医生的构成有显著影响,与由市政直接雇用的全科医生相比,签约全科医生数量的增加会降低死亡率。

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