Mills Anne
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
Proc Biol Sci. 2014 Aug 22;281(1789):20140451. doi: 10.1098/rspb.2014.0451.
Health economics is a relatively new discipline, though its antecedents can be traced back to William Petty FRS (1623-1687). In high-income countries, the academic discipline and scientific literature have grown rapidly since the 1960s. In low- and middle-income countries, the growth of health economics has been strongly influenced by trends in health policy, especially among the international and bilateral agencies involved in supporting health sector development. Valuable and influential research has been done in areas such as cost-benefit and cost-effectiveness analysis, financing of healthcare, healthcare provision, and health systems analysis, but there has been insufficient questioning of the relevance of theories and policy recommendations in the rich world literature to the circumstances of poorer countries. Characteristics such as a country's economic structure, strength of political and social institutions, management capacity, and dependence on external agencies, mean that theories and models cannot necessarily be transferred between settings. Recent innovations in the health economics literature on low- and middle-income countries indicate how health economics can be shaped to provide more relevant advice for policy. For this to be taken further, it is critical that such countries develop stronger capacity for health economics within their universities and research institutes, with greater local commitment of funding.
卫生经济学是一门相对较新的学科，尽管其前身可以追溯到英国皇家学会会员威廉·配第（1623 - 1687）。在高收入国家，自20世纪60年代以来，这一学科领域和科学文献发展迅速。在低收入和中等收入国家，卫生经济学的发展受到卫生政策趋势的强烈影响，尤其是在参与支持卫生部门发展的国际和双边机构中。在成本效益分析、医疗保健融资、医疗服务提供和卫生系统分析等领域已经开展了有价值且有影响力的研究，但对于富裕国家文献中的理论和政策建议与较贫穷国家情况的相关性，人们的质疑还不够。一个国家的经济结构、政治和社会机构的实力、管理能力以及对外部机构的依赖等特征意味着理论和模型不一定能在不同环境之间进行移植。关于低收入和中等收入国家的卫生经济学文献中的最新创新表明了如何对卫生经济学进行塑造，以便为政策提供更具相关性的建议。要进一步推进这一点，至关重要的是这些国家在其大学和研究机构内发展更强的卫生经济学能力，并加大当地资金投入。
