Division of Health Policy and Administration, Yale School of Public Health, 60 College Street, New Haven, Connecticut 06520, USA.
BMJ Qual Saf. 2011 Oct;20(10):826-31. doi: 10.1136/bmjqs.2010.048363. Epub 2011 Mar 29.
To examine variations in health service expenditures and social services expenditures across Organisation for Economic Co-operation and Development (OECD) countries and assess their association with five population-level health outcomes.
A pooled, cross-sectional analysis using data from the 2009 release of the OECD Health Data 2009 Statistics and Indicators and OECD Social Expenditure Database.
OECD countries (n = 30) from 1995 to 2005.
Life expectancy at birth, infant mortality, low birth weight, maternal mortality and potential years of life lost.
Health services expenditures adjusted for gross domestic product (GDP) per capita were significantly associated with better health outcomes in only two of five health indicators; social services expenditures adjusted for GDP were significantly associated with better health outcomes in three of five indicators. The ratio of social expenditures to health expenditures was significantly associated with better outcomes in infant mortality, life expectancy and increased potential life years lost, after adjusting for the level of health expenditures and GDP.
Attention to broader domains of social policy may be helpful in accomplishing improvements in health envisioned by advocates of healthcare reform.
考察经济合作与发展组织（OECD）国家之间卫生服务支出和社会服务支出的变化，并评估其与五项人口健康结果的关系。
利用 OECD 健康数据 2009 统计和指标以及 OECD 社会支出数据库 2009 年发布的数据进行的汇总、横截面分析。
1995 年至 2005 年期间的 OECD 国家（n=30）。
出生时预期寿命、婴儿死亡率、低出生体重、孕产妇死亡率和潜在生命损失年数。
仅在两个健康指标中的两个中，经人均国内生产总值（GDP）调整后的卫生服务支出与更好的健康结果显著相关；经 GDP 调整后的社会服务支出与五个指标中的三个显著相关。在调整卫生支出和 GDP 水平后，社会支出与卫生支出的比例与婴儿死亡率、预期寿命和潜在生命损失年数的增加显著相关。
关注更广泛的社会政策领域可能有助于实现医疗改革倡导者所设想的健康改善。
