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医疗保健融资在促进健康方面的成效:增加支出就能改善健康状况吗?

The effectiveness of health care finance in promoting health: does the condition of health get better by spending more?

作者信息

Aissaoui Nasreddine, Hamaizia Lamia, Brika Said Khalfa Mokhtar, Laamari Ahmed

机构信息

Faculty of Economics, Business and Management Sciences, Oum El Bouaghi University, Oum El Bouaghi, Algeria.

Department of Administrative Sciences, Applied College, University of Bisha, Bisha, Saudi Arabia.

出版信息

Pan Afr Med J. 2022 Jun 6;42:95. doi: 10.11604/pamj.2022.42.95.35133. eCollection 2022.

Abstract

Medical research in the United States remains a global reference, endowed with unrivalled financing, a source of endless advancements, and recognized with many accolades; with 45 per cent of the winners, the United States outrageously dominates the Nobel Prize for Medicine. The volume of health spending in the United States is far more than any other country; however, the health outcomes are far below expectation. An American child Born in 2016 will live on average 78.6 years, which places the country around the thirty-fifth place in the world, somewhere between Cuba and Qatar; the United States has other modest results, as evidenced by the ranking of countries in terms of infant mortality in 2015, which placed the country 33 out of 35 member countries, ahead of only Turkey and Mexico. Although the United States ranks 35th out of 190 countries based on infant mortality in 2015, it is still far behind Cuba, which was 30 and the first "non-high" income country. In 2016, US health expenditures/gross domestic product (GDP) exceeded 16%, with an average of 10,000 USD/inhabitants, while Cuban health expenditures/GDP did not exceed 11% during the same period. We aim through the present work to show that the state of health doesn't improve by spending more. However, it improves by spending more on programs that we know from the evidence can improve health outcomes.

摘要

美国的医学研究仍然是全球的参照标准,拥有无与伦比的资金支持,是无尽进步的源泉,并荣获众多赞誉;在诺贝尔医学奖得主中,美国占比45%,毫无争议地占据主导地位。美国的医疗支出规模远超其他任何国家;然而,其健康成果却远低于预期。2016年出生的美国儿童平均寿命为78.6岁,在世界排名中位列第三十五位左右,介于古巴和卡塔尔之间;美国在其他方面的表现也较为平平,以2015年各国婴儿死亡率排名为例,美国在35个成员国中位列第33位,仅领先于土耳其和墨西哥。尽管在2015年,美国在190个国家的婴儿死亡率排名中位列第35位,但仍远远落后于古巴,古巴排名第30位,是首个“非高收入”国家。2016年,美国的医疗支出占国内生产总值(GDP)的比例超过16%,人均支出平均为10,000美元,而古巴同期的医疗支出占GDP的比例未超过11%。我们通过本研究旨在表明,增加支出并不能改善健康状况。然而,通过将更多资金投入到那些基于证据可知能够改善健康成果的项目上,健康状况会得到改善。

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