| 引用本文：Aaron Reeves, Martin McKee, Sanjay Basu, David Stuckler.政治经济紧缩与卫生服务——基于1995—2011年27个欧洲国家费用变化的跨国分析[J].中国卫生政策研究,2014,7(4):73-80 |
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| 政治经济紧缩与卫生服务——基于1995—2011年27个欧洲国家费用变化的跨国分析 |
| 投稿时间：2014-01-17 修订日期：2014-02-13 PDF全文浏览 HTML全文浏览 |
| Aaron Reeves1, Martin McKee2, Sanjay Basu2,3, David Stuckler1,2 |
1. 牛津大学社会学系 英国牛津 OX13UQ;
2. 伦敦卫生与热带病医学院 英国伦敦 WC1H9SH;
3. 斯坦福大学医学院 美国帕洛阿尔托 CA94305 |
| 摘要:在经济衰退期间卫生支出为何呈现出多样化？本文采用1995—2011年27个欧洲国家的数据，对可能引起卫生支出变化的政治、经济和卫生体系等关键因素进行评估。纠正之前存在的时间趋势，采用随机效应模型和固定效应模型对2013年欧盟统计局、国际货币基金组织和世界银行的数据进行了测量和评估。研究发现，政府卫生支出的削减与经济衰退的程度关系不大；执政党的意识形态也不会对政府卫生支出产生很大影响。相反，税收每减少100美元，卫生支出将减少2.72美元。在控制可能的混淆因素后，国际货币基金组织贷款国家比非贷款国家更有可能削减政府卫生支出。在欧盟成员国中，与经济条件和政党意识形态等因素相比，向国际金融机构贷款、税收减少以及实施削减政策等可能更会导致政府卫生支出的削减。 |
| 关键词:政治经济 紧缩 衰退 国际货币基金组织 卫生服务 |
| 基金项目:欧盟委员会资助项目（278511） |
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| The political economy of austerity and healthcare：Cross-national analysis of expenditure changes in 27 European nations 1995—2011 |
| Aaron Reeves1, Martin McKee2, Sanjay Basu2,3, David Stuckler1,2 |
1. Department of Sociology, University of Oxford, Oxford OX13UQ, UK;
2. London School of Hygiene and Tropical Medicine, London WC1H9SH, UK;
3. School of Medicine, Stanford University, Palo Alto CA94305, USA |
| Abstract:Why have patterns of healthcare spending varied during the Great Recession? Using cross-national, harmonized data for 27 EU countries from 1995 to 2011, we evaluated political, economic, and health system determinants of recent changes to healthcare expenditure.Data from Euro Stat, the IMF, and World Bank (2013 editions) were evaluated using multivariate random-and fixed-effects models, correcting for pre-existing time-trends.Reductions in government health expenditure were not significantly associated with magnitude of economic recessions.Nor did ideology of governing parties have an effect. In contrast, each $100 reduction in tax revenue was associated with a $2.72 drop in health spending.IMF borrowers were significantly more likely to reduce healthcare budgets than non-IMF borrowers, even after correcting for potential confounding by indication.Exposure to lending from international financial institutions, tax revenue falls, and decisions to implement cuts correlate more closely than underlying economic conditions or orientation of political parties with healthcare expenditure change in EU member states. |
| Key words:Political economy Austerity Recession IMF Healthcare |
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