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亚洲主要经济体医疗保健支出(无)效率的预测因素——经合组织国家与非经合组织国家的比较

Predictors of (in)efficiencies of Healthcare Expenditure Among the Leading Asian Economies - Comparison of OECD and Non-OECD Nations.

作者信息

Jakovljevic Mihajlo, Sugahara Takuma, Timofeyev Yuriy, Rancic Nemanja

机构信息

Department of Global Health Economics and Policy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.

Institute of Comparative Economics, Hosei University, Tokyo, Japan.

出版信息

Risk Manag Healthc Policy. 2020 Oct 21;13:2261-2280. doi: 10.2147/RMHP.S266386. eCollection 2020.

Abstract

PURPOSE

The goal of this study was to assess the effectiveness of healthcare spending among the leading Asian economies.

METHODS

We have selected a total of nine Asian nations, based on the strength of their economic output and long-term real GDP growth rates. The OECD members included Japan and the Republic of Korea, while the seven non-OECD nations were China, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand. Healthcare systems efficiency was analyzed over the period 1996-2017. To assess the effectiveness of healthcare expenditure of each group of countries, the two-way fixed effects model (country- and year effects) was used.

RESULTS

Quality of governance and current health expenditure determine healthcare system performance. Population density and urbanization are positively associated with a healthy life expectancy in the non-OECD Asian countries. In this group, unsafe water drinking has a statistically negative effect on healthy life expectancy. Interestingly, only per capita consumption of carbohydrates is significantly linked with healthy life expectancy. In these non-OECD Asian countries, unsafe water drinking and per capita carbon dioxide emissions increase infant mortality. There is a strong negative association between GDP per capita and infant mortality in both sub-samples, although its impact is far larger in the OECD group. In Japan and South Korea, unemployment is negatively associated with infant mortality.

CONCLUSION

Japan outperforms other countries from the sample in major healthcare performance indicators, while South Korea is ranked second. The only exception is per capita carbon dioxide emissions, which have maximal values in the Republic of Korea and Japan. Non-OECD nations' outcomes were led by China, as the largest economy. This group was characterized with substantial improvement in efficiency of health spending since the middle of the 1990s. Yet, progress was noted with remarkable heterogeneity within the group.

摘要

目的

本研究的目的是评估亚洲主要经济体的医疗保健支出效果。

方法

我们根据经济产出实力和长期实际国内生产总值增长率,总共选择了9个亚洲国家。经合组织成员国包括日本和韩国,而7个非经合组织国家是中国、印度、印度尼西亚、马来西亚、巴基斯坦、菲律宾和泰国。对1996 - 2017年期间的医疗保健系统效率进行了分析。为评估每组国家医疗保健支出的效果,使用了双向固定效应模型(国家和年份效应)。

结果

治理质量和当前医疗保健支出决定医疗保健系统绩效。在非经合组织亚洲国家,人口密度和城市化与健康预期寿命呈正相关。在这一组中,不安全饮水对健康预期寿命有统计学上的负面影响。有趣的是,只有碳水化合物的人均消费量与健康预期寿命有显著关联。在这些非经合组织亚洲国家,不安全饮水和人均二氧化碳排放量会增加婴儿死亡率。在两个子样本中,人均国内生产总值与婴儿死亡率之间都存在很强的负相关,尽管其影响在经合组织组中远为更大。在日本和韩国,失业率与婴儿死亡率呈负相关。

结论

在主要医疗保健绩效指标方面,日本在样本中表现优于其他国家,而韩国排名第二。唯一的例外是人均二氧化碳排放量,在韩国和日本最高。非经合组织国家中,中国作为最大的经济体,其表现最为突出。自20世纪90年代中期以来,这一组国家在医疗保健支出效率方面有了显著提高。然而,该组内的进展存在显著的异质性。

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