Ranabhat Chhabi L, Atkinson Joel, Park Myung-Bae, Kim Chun-Bae, Jakovljevic Mihajlo
Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, South Korea.
Health Science Foundations and Study Center, Kathmandu, Nepal.
Front Pharmacol. 2018 Sep 18;9:960. doi: 10.3389/fphar.2018.00960. eCollection 2018.
There are substantial differences in long term health outcomes across countries, particularly in terms of both life expectancy at birth (LEAB) and healthy life expectancy (HALE). Socio-economic status, disease prevention approaches, life style and health financing systems all influence long-term health goals such as life expectancy. Within this context, universal health coverage (UHC) is expected to influence life expectancy as a comprehensive health policy. The aim of the study is to investigate this relationship between Universal Health Coverage (UHC) and life expectancy. A multi-country cross-sectional study was performed drawing on different sources of data (World Health Organization, UNDP-Education and World Bank) from 193 UN member countries, applying administrative record linkage theory. Descriptive statistics, -tests, Pearson correlations, hierarchical linear regressions were utilized as appropriate. Global average healthy life years was shown to be 61.34 ± 8.40 and life expectancy at birth was 70.00 ± 9.3. Standardized coefficients from regression analysis found UHC (0.34), child vaccination (Diphtheria Pertussis Tetanus-3: 0.17) and sanitation coverage (0.31) were associated with significantly increased life expectancy at birth. In contrast, population growth was associated with a decrease (0.29). Likewise, unit increases in child vaccination (DPT 3), sanitation and UHC would increase healthy life expectancy considerably (0.18, 0.31, and 0.40 respectively), whereas the same for population growth reduces healthy life expectancy by 0.28. Universal Health Coverage (UHC) is a comprehensive health system approach that facilitates a wide range of health services and significantly improves the life expectancy at birth and healthy life expectancy. This study suggests that specific programs to achieve UHC should be considered for countries that have not seen sufficient gains in life expectancy as part of the wider push to achieve the Sustainable Development Goal (SDG).
不同国家在长期健康结果方面存在显著差异，尤其是在出生时预期寿命（LEAB）和健康预期寿命（HALE）方面。社会经济地位、疾病预防方法、生活方式和卫生筹资系统都会影响诸如预期寿命等长期健康目标。在此背景下，全民健康覆盖（UHC）作为一项全面的卫生政策，有望对预期寿命产生影响。本研究的目的是调查全民健康覆盖（UHC）与预期寿命之间的这种关系。利用行政记录链接理论，对193个联合国成员国不同来源的数据（世界卫生组织、联合国开发计划署 - 教育数据和世界银行）进行了多国横断面研究。酌情使用了描述性统计、t检验、皮尔逊相关性和分层线性回归分析。全球平均健康生命年为61.34±8.40，出生时预期寿命为70.00±9.3。回归分析的标准化系数发现，全民健康覆盖（0.34）、儿童疫苗接种（白喉百日咳破伤风三联疫苗 - 第三剂：0.17）和卫生设施覆盖率（0.31）与出生时预期寿命的显著增加相关。相比之下，人口增长与之呈负相关（0.29）。同样，儿童疫苗接种（DPT第三剂）、卫生设施和全民健康覆盖每增加一个单位，健康预期寿命将大幅增加（分别为0.18、0.31和0.40），而人口增长每增加一个单位则会使健康预期寿命降低0.28。全民健康覆盖（UHC）是一种全面的卫生系统方法，它促进了广泛的卫生服务，并显著提高了出生时预期寿命和健康预期寿命。本研究表明，作为实现可持续发展目标（SDG）更广泛努力的一部分，对于在预期寿命方面尚未取得足够进展的国家，应考虑实施实现全民健康覆盖的具体方案。
