Smith Neale, Mitton Craig, Kershaw Paul
Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, 7th Floor, 828 W 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
School of Public Health, University of Alberta, Edmonton, AB, Canada.
Can J Public Health. 2016 Jun 27;107(1):e130-e132. doi: 10.17269/cjph.107.5184.
We argue that Canadian provincial governments should contain medical care spending in order to invest more in the social determinants of health (SDH). Others have said this, many times. Doing it has not proven easy. We therefore emphasize the potential contribution of the priority-setting and resource allocation literature. This literature identifies formal tools and approaches that have built cultures of support for resource shifts, while providing pragmatic means for advancing efficiency and equity. Although reallocation towards SDH from other areas of the health care system is financially viable and supported by existing research, it will require new emphasis on the design of population health interventions that make reallocation politically expedient.
我们认为，加拿大省级政府应控制医疗保健支出，以便在健康的社会决定因素（SDH）方面进行更多投资。其他人已经多次这样说过。但事实证明，做到这一点并不容易。因此，我们强调优先事项设定和资源分配文献的潜在贡献。该文献确定了一些正式的工具和方法，这些工具和方法营造了支持资源转移的文化，同时提供了提高效率和公平性的务实手段。尽管从医疗保健系统的其他领域向SDH重新分配资源在财务上是可行的，并且得到了现有研究的支持，但这将需要重新重视人口健康干预措施的设计，以使重新分配在政治上更便利。
