Govindaraj R, Chellaraj G, Murray C J
Department of Population and International Health, Harvard School of Public Health, Boston, MA 02115, USA.
Soc Sci Med. 1997 Jan;44(2):157-69. doi: 10.1016/s0277-9536(96)00097-4.
This paper presents the results of a study commissioned by the Latin American and Caribbean Technical Department of the World Bank to document and analyze health expenditures in Latin America and the Caribbean. In 1990, the countries of this region spent US$ 69 billion on health, with an average per capita health expenditure of US$ 162. On average, the countries spent 6.2% of their GDP on health, with the expenditures divided about equally between the public and private sectors. In both the public and private sectors, per capita health expenditures were positively and significantly correlated with per capita income. However, this relationship holds only for the public sector, when health expenditures are measured as a proportion of GDP. While several poorer countries were dependent on external assistance, with increasing income, the countries relied more on public expenditures to finance health care. Based on the limited time series data, it is evident that there was a considerable variation among countries regarding the proportion spent on capital investments, primary health care, and drugs, but not on salaries. Looking ahead, with increasing economic development, the proportion of GDP spent on health, along with public health expenditure as a proportion of total health expenditure, is likely to increase rapidly, while aid dependency is likely to decline.
本文展示了世界银行拉丁美洲和加勒比地区技术部委托开展的一项研究成果，该研究旨在记录和分析拉丁美洲和加勒比地区的卫生支出情况。1990年，该地区各国在卫生方面的支出为690亿美元，人均卫生支出为162美元。各国平均将其国内生产总值的6.2%用于卫生，公共部门和私营部门的支出大致相等。在公共部门和私营部门，人均卫生支出与人均收入均呈正相关且具有显著相关性。然而，当将卫生支出作为国内生产总值的比例来衡量时，这种关系仅在公共部门成立。虽然一些较贫穷国家依赖外部援助，但随着收入增加，这些国家更多地依靠公共支出为医疗保健提供资金。根据有限的时间序列数据，很明显各国在资本投资、初级卫生保健和药品方面的支出比例存在相当大的差异，但在薪资方面则不然。展望未来，随着经济的不断发展，卫生支出占国内生产总值的比例以及公共卫生支出占卫生总支出的比例可能会迅速上升，而对援助的依赖可能会下降。
