Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
Int J Public Health. 2017 Apr;62(3):361-370. doi: 10.1007/s00038-016-0935-4. Epub 2016 Dec 20.
Relationship between human resources for health and mortality remains inconclusive despite numerous studies published on the topic in the last decades. This paper investigates how and why methodological trade-offs implicitly made by researchers when using macro-data can in part explains this puzzling lack of agreement.
Using data from the Global Health Observatory, we build a model of the relationship between human resources and mortality, which we progressively alter by changing its scope, variables and analysis period. Then, we compare results among themselves to isolate the impact of methodological choices from other changes in the data.
Results demonstrate how methodological choices linked to (1) the analysis period, (2) the definition of health inputs, health outcomes and control variables and (3) the choice of specific variables as proxy for human resources and health outcomes affects the relationship between human resources and health outputs.
Results presented highlights the need for complementing existing macro-analysis with other analytical strategies, for better documenting methodological choices in research studies, as well as for further supporting countries' efforts to produce reliable and consistent data.
尽管过去几十年发表了许多关于这个主题的研究,但卫生人力与死亡率之间的关系仍不确定。本文研究了研究人员在使用宏观数据时所做的方法权衡是如何以及为何在一定程度上解释了这种令人费解的缺乏一致性。
使用来自全球卫生观察站的数据,我们构建了一个人力资源与死亡率之间关系的模型,我们通过改变其范围、变量和分析期来逐步改变该模型。然后,我们将结果相互比较,以将方法选择的影响与数据中的其他变化隔离开来。
结果表明,与(1)分析期、(2)卫生投入、卫生结果和控制变量的定义以及(3)特定变量作为人力资源和卫生结果替代指标的选择相关的方法选择如何影响人力资源与卫生结果之间的关系。
提出的结果强调了需要用其他分析策略来补充现有的宏观分析,以更好地记录研究中方法选择的情况,以及进一步支持各国努力生成可靠和一致的数据。