中国国家自然科学基金健康研究资助与疾病负担
NSFC health research funding and burden of disease in China.
作者信息
Xu Gelin, Zhang Zhizhong, Lv Qiushi, Li Yun, Ye Ruidong, Xiong Yunyun, Jiang Yongjun, Liu Xinfeng
机构信息
Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China.
出版信息
PLoS One. 2014 Nov 4;9(11):e111458. doi: 10.1371/journal.pone.0111458. eCollection 2014.
BACKGROUND
Allocation of health research funds among diseases has never been evaluated in China. This study aimed to examine the relationship between disease-specific funding levels of National Nature Science Foundation of China (NSFC), the main governmental resource for health research in China, and burden of disease.
METHODS
Funding magnitudes for 53 diseases or conditions were obtained from the website of NSFC. Measures of disease burden, mortality, years of life lost (YLLs) and disability-adjusted life years (DALYs), were derived from the Global Burden of Disease Study 2010. The relationship between NSFC funding and disease burden was analyzed with univariate linear regression. For each measure associated with funding, regression-derived estimates were used to calculate the expected funds for each disease. The actual and expected funds were then compared. We also evaluated the impacts of changes of disease burden metrics since 1990, and differences from the world averages on NSFC funding.
RESULTS
NSFC health research funding was associated with disease burden measured in mortality (R = 0.33, P = 0.02), YLLs (R = 0.39, P = 0.004), and DALYs (R = 0.40, P = 0.003). But none of the changes of mortality (R = 0.22, P = 0.12), YLLs (R = -0.04, P = 0.79) and DALYs (R = -0.003, P = 0.98) since 1990 was associated with the funding magnitudes. None of the differences of mortality (R = -0.11, P = 0.45), YLLs (R = -0.11, P = 0.43) and DALYs (R = -0.12, P = 0.38) from that of the concurrent world averages were associated with the funding magnitudes. Measured by DALY, stroke and COPD received the least funding compared to expected; while leukemia and diabetes received the most funding compared to expected.
CONCLUSION
Although NSFC funding were roughly associated with disease burden as measured in mortality, YLLs and DALYs. Some major diseases such as stroke were underfunded; while others such as leukaemia were overfunded. Change of disease burden during the last 20 years and country-specialized disease burden were not reflected in current allocation of NSFC funds.
背景
中国从未对卫生研究资金在不同疾病间的分配情况进行过评估。本研究旨在探究中国卫生研究的主要政府资金来源——国家自然科学基金（NSFC）在特定疾病上的资助水平与疾病负担之间的关系。
方法
从NSFC网站获取53种疾病或健康状况的资助金额。疾病负担指标、死亡率、生命损失年数（YLLs）和伤残调整生命年（DALYs）来自《2010年全球疾病负担研究》。采用单变量线性回归分析NSFC资助与疾病负担之间的关系。对于与资助相关的每个指标，利用回归得出的估计值计算每种疾病的预期资金。然后比较实际资金与预期资金。我们还评估了自1990年以来疾病负担指标变化以及与世界平均水平的差异对NSFC资助的影响。
结果
NSFC的卫生研究资助与以死亡率（R = 0.33，P = 0.02）、YLLs（R = 0.39，P = 0.004）和DALYs（R = 0.40，P = 0.003）衡量的疾病负担相关。但自1990年以来，死亡率（R = 0.22，P = 0.12）、YLLs（R = -0.04，P = 0.79）和DALYs（R = -0.003，P = 0.98）的变化均与资助金额无关。死亡率（R = -0.11，P = 0.45）、YLLs（R = -0.11，P = 0.43）和DALYs（R = -0.12，P = 0.38）与同期世界平均水平的差异均与资助金额无关。以DALY衡量，中风和慢性阻塞性肺疾病（COPD）获得的资助与预期相比最少；而白血病和糖尿病获得的资助与预期相比最多。
结论
尽管NSFC的资助与以死亡率、YLLs和DALYs衡量的疾病负担大致相关。但一些主要疾病如中风的资助不足；而另一些疾病如白血病则资助过度。过去20年疾病负担的变化以及国家特有的疾病负担在NSFC目前资金分配中未得到体现。
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