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预期寿命的决定因素:来自世界银行收入组的证据,采用面板虚拟变量交互方法。

Determinants of life expectancy: evidence from World Bank income groups using a panel dummy interaction approach.

作者信息

Sofi Sameer Ahmad, Yasmin Effat

机构信息

Department of Economics, University of Kashmir, Srinagar, India.

出版信息

Int J Health Care Qual Assur. 2025 Jul 1;38(3):181-197. doi: 10.1108/IJHCQA-03-2025-0026.

Abstract

PURPOSE

Achieving optimal health outcomes is central to global health policies. This study examines the impact of out-of-pocket (OOP) health expenditures and other determinants on life expectancy across income groups classified by the World Bank.

DESIGN/METHODOLOGY/APPROACH: Using panel data and a fixed-effects model with dummy interactions, the findings reveal that OOP expenditures reduce life expectancy more in low-income economies, underscoring the need to lower financial barriers to healthcare.

FINDINGS

Gross domestic product (GDP) per capita is significant for improving life expectancy more in low-income economies, but diminishing returns suggest aligning growth with health policies. Immunization consistently improves life expectancy, highlighting preventive care's importance. Unemployment limits healthcare access, particularly in low-middle-income economies, requiring policies to address economic instability. Alcohol consumption adversely affects life expectancy in high-income economies, highlighting the impact of lifestyle changes and the need for regulatory interventions.

PRACTICAL IMPLICATIONS

By exploring the interplay of health expenditures, socioeconomic factors and lifestyle risks, the study offers insights for equitable global health policies aimed at improving health outcomes across income groups.

ORIGINALITY/VALUE: (1) While previous studies have analysed the impact of various socio-economic factors on life expectancy in developed economies, little is known about the impact of these factors in Low and Middle Income Economies. (2) Moreover, the impact of out-of-pocket health expenditure on life expectancy has not been comprehensively analysed across different income groups. (3) Findings reveal that out-of-pocket expenditures negatively affect life expectancy more in low-income economies than in high-income economies, emphasizing the need for reducing the financial burden to improve healthcare access. (4) Alcohol consumption adversely impacts life expectancy in high-income economies, highlighting the need for regulatory interventions targeting lifestyle-related risks. (5) This study enhances understanding of how health expenditures, socio-economic factors, and lifestyle choices influence life expectancy across income groups, offering insights to guide equitable global health policies.

摘要

目的

实现最佳健康结果是全球卫生政策的核心。本研究考察了自付医疗费用及其他决定因素对世界银行划分的不同收入群体预期寿命的影响。

设计/方法/途径:利用面板数据和带有虚拟变量交互项的固定效应模型,研究结果表明,自付费用对低收入经济体预期寿命的降低作用更大,这凸显了降低医疗保健经济障碍的必要性。

研究结果

人均国内生产总值(GDP)对低收入经济体提高预期寿命具有显著作用,但收益递减表明应使经济增长与卫生政策保持一致。免疫接种持续提高预期寿命,凸显了预防保健的重要性。失业限制了医疗保健的可及性,尤其是在中低收入经济体,因此需要制定政策来应对经济不稳定问题。在高收入经济体中,酒精消费对预期寿命产生不利影响,这凸显了生活方式变化的影响以及监管干预的必要性。

实际意义

通过探究医疗费用、社会经济因素和生活方式风险之间的相互作用,本研究为旨在改善不同收入群体健康结果的公平全球卫生政策提供了见解。

原创性/价值:(1)虽然先前的研究分析了各种社会经济因素对发达经济体预期寿命的影响,但对于这些因素在低收入和中等收入经济体中的影响知之甚少。(2)此外,尚未对不同收入群体自付医疗费用对预期寿命的影响进行全面分析。(3)研究结果表明,自付费用对低收入经济体预期寿命的负面影响大于高收入经济体,强调了减轻经济负担以改善医疗保健可及性的必要性。(4)酒精消费对高收入经济体的预期寿命产生不利影响,凸显了针对与生活方式相关风险进行监管干预的必要性。(5)本研究增进了对医疗费用、社会经济因素和生活方式选择如何影响不同收入群体预期寿命的理解,为指导公平的全球卫生政策提供了见解。

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