The Quality of Government Institute, Department of Political Science, University of Gothenburg, Gothenburg, Sweden.
Health Econ Policy Law. 2011 Oct;6(4):529-47. doi: 10.1017/S174413311000023X.
In many poor countries, over 80% of the population have experienced corrupt practices in the health sector. In rich countries, corruption takes other forms such as overbilling. The causal link between low levels of the quality of government (QoG) and population health can be either direct or indirect. Using cross-sectional data from more than 120 countries, our findings are that more of a QoG variable is positively associated with higher levels of life expectancy, lower levels of mortality rates for children and mothers, higher levels of healthy life expectancies and higher levels of subjective health feelings. In contrast to the strong relationships between the QoG variables and the health indicators, the relationship between the health-spending measures and population health are rather weak most of the time and occasionally non-existent. Moreover, for private health spending as well as for private share of total health spending, the relation to good health is close to zero or slightly negative. The policy recommendation coming out of our study to improve health levels around the world, in rich countries as well as in poor countries, is to improve the QoG and to finance health care with public, not private, money.
在许多贫穷国家,超过 80%的人口在医疗领域经历过腐败行为。在富裕国家,腐败采取了其他形式,如超额计费。政府质量(QoG)水平低与人口健康之间的因果关系可能是直接的,也可能是间接的。我们利用来自 120 多个国家的横截面数据发现,更多的 QoG 变量与更高的预期寿命、更低的儿童和母亲死亡率、更高的健康预期寿命以及更高的主观健康感受水平呈正相关。与 QoG 变量与健康指标之间的强烈关系形成鲜明对比的是,卫生支出措施与人口健康之间的关系在大多数情况下相当微弱,有时甚至不存在。此外,对于私人卫生支出以及私人卫生总支出的份额,与良好健康的关系几乎为零或略微负面。我们的研究提出的改善全球(包括富裕国家和贫穷国家)健康水平的政策建议是改善 QoG,并利用公共资金而不是私人资金为医疗保健提供资金。
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