Brown Timothy T, Martinez-Gutierrez Maria S, Navab Bahar
School of Public Health,University of California,Berkeley,CA,USA.
Health Econ Policy Law. 2014 Jul;9(3):251-69. doi: 10.1017/S1744133114000024. Epub 2014 Feb 13.
We estimate the effect of changes in the per capita expenditures of county departments of public health on county-level general health status. Using panel data on 40 counties in California (2001-2009), dynamic panel estimation techniques are combined with the Lewbel instrumental variable technique to estimate an aggregate demand for health function that measures the causal cumulative impact that per capita public health expenditures have on county-level general health status. We find that a $10 long-term increase in per capita public health expenditures would increase the percentage of the population reporting good, very good or excellent health by 0.065 percentage points. Each year expenditures were increased would result in ∼24,000 individuals moving from the 'poor or fair health' category to the 'good, very good or excellent health' category across these 40 counties. In terms of the overall impact of county public health departments on general health status, at current funding levels, each annual expenditure cycle results in over 207,000 individuals being in the 'good, very good or excellent' categories of health status rather than the 'poor or fair' categories.
我们估计了县公共卫生部门人均支出的变化对县级总体健康状况的影响。利用加利福尼亚州40个县的面板数据（2001 - 2009年），动态面板估计技术与勒韦尔工具变量技术相结合，以估计健康函数的总需求，该函数衡量人均公共卫生支出对县级总体健康状况的因果累积影响。我们发现，人均公共卫生支出长期增加10美元，将使报告健康状况良好、非常好或优秀的人口百分比提高0.065个百分点。在这40个县中，每年支出增加都会使约24,000人从“健康状况差或一般”类别转变为“健康状况良好、非常好或优秀”类别。就县公共卫生部门对总体健康状况的总体影响而言，在当前资金水平下，每个年度支出周期都会使超过207,000人处于“健康状况良好、非常好或优秀”类别，而非“健康状况差或一般”类别。
