Midttun Linda, Hagen Terje P
SINTEF Health Service Research and Institute of Health Management and Health Economics, University of Oslo; Health Organisation Research Norway (HORN), Norway.
Health Econ Policy Law. 2006 Jul;1(Pt 3):277-98. doi: 10.1017/S1744133106003045.
Privatizations of public services are often driven by economic scarcity and changes in political leadership, in particular election victories for conservative or neoliberal political parties. Data from Norwegian counties on numbers of medical specialists in secondary care over a period of 11 years (1991-2001) allow us to analyse effects of economic, socioeconomic, and political factors on supply of both public and private specialists and the private-public mix. We find striking variations between the main explanatory factors related to public and private supply. Supply of public specialists is explained by counties' revenue levels and demographic factors and is not affected by the party composition of councils. The supply of private specialist medical services is negatively related to the proportion of elderly patients. The scarcity hypothesis is confirmed as lower county revenue levels increase both the absolute and relative proportions of private supply. Political composition of councils affects the private proportion of medical specialists as increased representation of conservatives leads to privatization.
公共服务的私有化往往是由经济稀缺以及政治领导层的变化推动的，特别是保守派或新自由主义政党在选举中获胜。挪威各县11年（1991 - 2001年）期间二级医疗中医学专家数量的数据，使我们能够分析经济、社会经济和政治因素对公共和私人专家供应以及公私混合情况的影响。我们发现，与公共和私人供应相关的主要解释因素之间存在显著差异。公共专家的供应由各县的收入水平和人口因素来解释，不受议会政党构成的影响。私人专科医疗服务的供应与老年患者的比例呈负相关。稀缺假说得到证实，因为较低的县收入水平会增加私人供应的绝对比例和相对比例。议会的政治构成会影响医学专家的私人比例，因为保守派代表的增加会导致私有化。
