欧洲国家医疗资源、医疗体系与人口健康之间的关联。
Association between healthcare resources, healthcare systems, and population health in European countries.
作者信息
Kittipittayakorn Cholada
机构信息
Department of Industrial Economics, Blekinge Institute of Technology, 37179, Karlskrona, Sweden.
出版信息
BMC Health Serv Res. 2025 May 19;25(1):720. doi: 10.1186/s12913-024-11743-0.
BACKGROUND
Recently, the demand for care has risen, while in contrast, healthcare resources remain limited. These resources include health expenditure, the number of physicians, nurses, and hospital beds. Many studies have revealed that healthcare resources are one of the most critical factors contributing to a population's health status. The healthcare system plays a key role in transforming these resources into health outcomes, which are widely used as indicators to measure population health and the performance of healthcare systems. Previous work has primarily investigated the relationship between health expenditure or the number of doctors and population health. However, the association between healthcare resources as a whole has yet to be widely examined.
METHODS
This study utilized multilevel regression analysis to explore the association between healthcare resources, healthcare systems, and population health outcomes across 25 European countries. The healthcare systems in these countries are primarily categorized into two types: Beveridge-type and Bismarck-type. In addition to regression analysis, descriptive statistics were used to analyze the allocation patterns of healthcare resources. Welch's t-test was employed to compare the performance metrics of the Beveridge-type and Bismarck-type healthcare systems, providing a statistical basis for understanding differences in their effectiveness.
RESULTS
The regression analysis revealed positive correlations between health expenditure per capita, the number of physicians, and nurses, and life expectancy at birth, while the number of hospital beds showed a negative correlation. Conversely, infant mortality was negatively correlated with health expenditure per capita and the number of physicians and nurses, and positively correlated with the number of hospital beds. The models did not find statistical significance in the effects of healthcare system type (Beveridge-type or Bismarck-type) on life expectancy at birth or infant mortality rates. Additionally, Welch's t-test indicated that the Beveridge-type healthcare system generally showed better performance outcomes compared to the Bismarck-type system.
CONCLUSIONS
The findings indicate that higher allocations of certain healthcare resources, such as hospital beds, are associated with poorer health outcomes, which suggests potential inefficiencies in resource utilization. Observations also show that countries using the same healthcare systems tend to have similar patterns of resource allocation, which may influence the performance of these systems. Policymakers should consider these associations when planning resource allocation and when selecting or modifying healthcare system models in their countries.
背景
近年来,医疗护理需求不断上升,而相比之下,医疗资源仍然有限。这些资源包括卫生支出、医生数量、护士数量和医院病床数。许多研究表明,医疗资源是影响人群健康状况的最关键因素之一。医疗系统在将这些资源转化为健康结果方面起着关键作用,健康结果被广泛用作衡量人群健康和医疗系统绩效的指标。以往的研究主要调查了卫生支出或医生数量与人群健康之间的关系。然而,作为一个整体的医疗资源之间的关联尚未得到广泛研究。
方法
本研究利用多层次回归分析,探讨了25个欧洲国家的医疗资源、医疗系统与人群健康结果之间的关联。这些国家的医疗系统主要分为两类:贝弗里奇型和俾斯麦型。除了回归分析外,还使用描述性统计分析了医疗资源的分配模式。采用韦尔奇t检验比较贝弗里奇型和俾斯麦型医疗系统的绩效指标,为理解它们在有效性方面的差异提供统计依据。
结果
回归分析显示,人均卫生支出、医生数量和护士数量与出生时预期寿命呈正相关,而医院病床数量呈负相关。相反,婴儿死亡率与人均卫生支出、医生数量和护士数量呈负相关,与医院病床数量呈正相关。模型未发现医疗系统类型(贝弗里奇型或俾斯麦型)对出生时预期寿命或婴儿死亡率有统计学意义。此外,韦尔奇t检验表明,与俾斯麦型系统相比,贝弗里奇型医疗系统总体上表现出更好的绩效结果。
结论
研究结果表明,某些医疗资源(如医院病床)的较高分配与较差的健康结果相关,这表明资源利用可能存在低效情况。观察还表明,采用相同医疗系统的国家往往具有相似的资源分配模式,这可能会影响这些系统的绩效。政策制定者在规划资源分配以及在本国选择或修改医疗系统模式时应考虑这些关联。
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