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公共卫生支出和私人卫生支出对健康状况影响的比较:东地中海国家的面板数据分析。

Comparison of the effects of public and private health expenditures on the health status: a panel data analysis in eastern mediterranean countries.

机构信息

School of Health Management and Information Sciences, Tehran University of Medical sciences, Tehran, Iran.

School of Health Management and Information Sciences, Shiraz University of Medical sciences, Shiraz, Iran.

出版信息

Int J Health Policy Manag. 2013 Jul 20;1(2):163-7. doi: 10.15171/ijhpm.2013.29. eCollection 2013 Aug.

Abstract

BACKGROUND

Health expenditures are divided in two parts of public and private health expenditures. Public health expenditures contain social security spending, taxing to private and public sectors, and foreign resources like loans and subventions. On the other hand, private health expenditures contain out of pocket expenditures and private insurances. Each of these has different effects on the health status. The present study aims to compare the effects of these expenditures on health in Eastern Mediterranean Region (EMR).

METHODS

In this study, infant mortality rate was considered as an indicator of health status. We estimated the model using the panel data of EMR countries between 1995 and 2010. First, we used Pesaran CD test followed by Pesaran's CADF unit root test. After the confirmation of having unit root, we used Westerlund panel cointegration test and found that the model was cointegrated and then after using Hausman and Breusch-Pagan tests, we estimated the model using the random effects.

RESULTS

The results showed that the public health expenditures had a strong negative relationship with infant mortality rate. However, a positive relationship was found between the private health expenditures and infant mortality rate (IMR). The relationship for public health expenditures was significant, but for private health expenditures was not.

CONCLUSION

The study findings showed that the public health expenditures in the EMR countries improved health outcome, while the private health expenditures did not have any significant relationship with health status, so often increasing the public health expenditures leads to reduce IMR. But this relationship was not significant because of contradictory effects for poor and wealthy peoples.

摘要

背景

卫生支出分为公共卫生支出和私人卫生支出两部分。公共卫生支出包含社会保障支出、对私人和公共部门的征税以及贷款和赠款等外国资源。另一方面,私人卫生支出包含自付支出和私人保险。这些支出对健康状况都有不同的影响。本研究旨在比较东地中海地区(EMR)这些支出对健康的影响。

方法

在这项研究中,婴儿死亡率被视为健康状况的指标。我们使用 EMR 国家 1995 年至 2010 年的面板数据来估计模型。首先,我们使用 Pesaran CD 检验,然后使用 Pesaran 的 CADF 单位根检验。在确认存在单位根后,我们使用 Westerlund 面板协整检验,发现模型是协整的,然后使用豪斯曼和 Breusch-Pagan 检验,我们使用随机效应估计模型。

结果

结果表明,公共卫生支出与婴儿死亡率呈强负相关。然而,私人卫生支出与婴儿死亡率(IMR)呈正相关。公共卫生支出的关系是显著的,但私人卫生支出的关系不显著。

结论

研究结果表明,EMR 国家的公共卫生支出改善了健康结果,而私人卫生支出与健康状况没有任何显著关系,因此增加公共卫生支出通常会降低 IMR。但由于对穷人和富人的影响相互矛盾,这种关系并不显著。

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