更多的公共卫生支出能带来更健康的结果吗？
Does More Public Health Spending Buy Better Health?
作者信息
Marton James, Sung Jaesang, Honore Peggy
机构信息
Department of Economics, Andrew Young School of Policy Studies, Georgia State University, Atlanta, GA, USA.
Louisiana State University Health Science Center School of Public Health, New Orleans, LA, USA.
出版信息
Health Serv Res Manag Epidemiol. 2015 Apr 13;2:2333392815580750. doi: 10.1177/2333392815580750. eCollection 2015 Jan-Dec.
BACKGROUND
In this article, we attempt to address a persistent question in the health policy literature: Does more public health spending buy better health? This is a difficult question to answer due to unobserved differences in public health across regions as well as the potential for an endogenous relationship between public health spending and public health outcomes.
METHODS
We take advantage of the unique way in which public health is funded in Georgia to avoid this endogeneity problem, using a twelve year panel dataset of Georgia county public health expenditures and outcomes in order to address the "unobservables" problem.
RESULTS
We find that increases in public health spending lead to increases in mortality by several different causes, including early deaths and heart disease deaths. We also find that increases in such spending leads to increases in morbidity from heart disease.
CONCLUSIONS
Our results suggest that more public health funding may not always lead to improvements in health outcomes at the county level.
背景
在本文中，我们试图解决卫生政策文献中一个长期存在的问题：更多的公共卫生支出是否能带来更好的健康状况？由于各地区公共卫生存在未被观察到的差异，以及公共卫生支出与公共卫生结果之间可能存在内生关系，这个问题很难回答。
方法
我们利用佐治亚州公共卫生资金筹集的独特方式来避免这种内生性问题，使用佐治亚州县公共卫生支出和结果的十二年面板数据集来解决“不可观察因素”问题。
结果
我们发现，公共卫生支出的增加会导致包括过早死亡和心脏病死亡在内的几种不同原因导致的死亡率上升。我们还发现，此类支出的增加会导致心脏病发病率上升。
结论
我们的结果表明，更多的公共卫生资金并不总是能在县级层面带来健康结果的改善。
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