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性别与健康结果:医疗体系及其筹资对男女预期寿命的影响。

Gender and health outcomes: the impact of healthcare systems and their financing on life expectancies of women and men.

机构信息

Department of Political Science and the Mosse/Weinstein Center for Jewish Studies at the University of Wisconsin-Madison, USA.

出版信息

Soc Sci Med. 2010 Mar;70(6):886-95. doi: 10.1016/j.socscimed.2009.11.018. Epub 2010 Jan 21.

Abstract

The paper considers the impact of healthcare systems and how they are financed on the life expectancies (LEs) of women and men in 19 OECD countries during the period 1990-2005 using OECD Health Data 2009. There is a gap in life expectancy (LE) between men and women, with women living longer than men, and most studies point to socio-economic variables and lifestyle and health-related behaviors. The role of healthcare systems and access to medical services is still disputed. This article proposes a number of adjustments to previous studies. First, it uses several variables broken down according to gender. Second, it considers healthcare systems by measuring their national expenditure as well as their public and private sources of funding. Third, it includes factors indirectly affecting health as expenditures on other realms of social policy. Fourth, it examines the factors impacting LEs of women and men at birth and at 65. Using a hierarchical model of panel-data regressions, the study finds: (1) there is a marginal impact on LEs at birth for both genders and greater impact on LEs at 65 for both genders; (2) a public mode of funding has greater effect than private; (3) the findings that men benefit more from access to medical services might be the result of the variables controlled in the analysis.

摘要

本文使用 OECD 2009 年健康数据,考察了 19 个经合组织国家在 1990-2005 年间医疗保健系统及其筹资方式对女性和男性预期寿命的影响。男性和女性的预期寿命存在差距,女性比男性长寿,大多数研究指出,社会经济变量、生活方式和与健康相关的行为是造成这种差距的主要原因。医疗保健系统和获得医疗服务的机会的作用仍存在争议。本文对以往的研究提出了一些调整。首先,它使用了根据性别细分的几个变量。其次,它通过衡量医疗保健系统的国家支出以及公共和私人资金来源来考察医疗保健系统。第三,它将间接影响健康的因素(如其他社会政策领域的支出)纳入考量。第四,它研究了影响女性和男性出生时和 65 岁时预期寿命的因素。利用面板数据回归的层次模型,研究发现:(1) 对于两性而言,医疗保健系统的筹资模式对出生时的预期寿命有一定影响,而对 65 岁时的预期寿命影响更大;(2) 公共筹资模式比私人模式影响更大;(3) 男性从获得医疗服务中获益更多的原因可能是分析中控制了变量。

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