بررسی تطبیقی مخارج خصوصی و عمومی مراقبت‌های سلامتی

نوع مقاله : پژوهشی

نویسندگان

1 استادیار، دانشگاه پیام نور، تهران، ایران

2 استاد، دانشگاه پیام نور، تهران، ایران

3 دانشجوی کارشناسی ارشد، دانشگاه پیام نور، تهران، ایران

چکیده

اغلب کشورهای جهان در سال­های گذشته رشد سریعی را در هزینه‌­های مراقبت سلامت خود تجربه کرده‌­اند. با توجه به رشد فزاینده هزینه­‌های این بخش، تشخیص مؤلفه‌­های موثر بر مخارج بهداشتی امری مهم به‌نظر می­‌رسد. هدف تحقیق حاضر بررسی تطبیقی مخارج مراقبت‌های بهداشتی خصوصی و عمومی در کشورهای منتخب توسعه یافته و در حال توسعه است. داده‌ها از نوع تلفیقی (پانل) در قالب 15 کشور توسعه یافته و در حال توسعه برای دوره زمانی 2000-2019 است و بر آن اساس متغیرهای موثر بر مخارج حوزه سلامت برای هر دو بخش خصوصی و عمومی مورد بررسی قرار گرفته است. متغیرهای تولید ناخالص داخلی، امید به زندگی، جمعیت بالای 65 سال و نرخ شهرنشینی در هر دو گروه از خصوصی و عمومی در کشورهای منتخب اثری مثبت و معنادار بر مخارج مراقبت بهداشتی داشته، امّا جمعیت زیر 14 سال در هر دو گروه کشورها ارتباط منفی و معنادار با مخارج مراقبت‌های بهداشتی در هر دو بخش داشته است؛ همچنین متغیر پرداخت از جیب در کشورهای توسعه یافته منفی و معنادار و در کشورهای در حال توسعه مثبت و معنادار بوده است و ضریب متغیر کمک‌های خارجی در کشورهای در حال توسعه منفی و معنادار است و در نهایت طبق یافته­‌ها ارتباط معناداری بین نرخ باسوادی با هزینه‌های سلامت وجود ندارد. با توجه به سهم بخش عمومی و بخش خصوصی از مخارج بهداشتی در کشورهای در حال توسعه و توسعه یافته، دولت­‌ها در نقش بزرگ‌ترین نهاد عمومی، باید اقدامات لازم را در جهت افزایش سهم بخش عمومی از مخارج بهداشتی انجام دهند.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Comparative study of care expenditures for private and public health

نویسندگان [English]

  • Samira Motaghi 1
  • Yeganeh Mousavi Jahromi 2
  • Ali Zandi Karim Khani 3
1 Assistant Professor, Payam Noor university, Tehran, Iran
2 Professor, Payam Noor university, Tehran, Iran
3 MA student,, Payam Noor university, Tehran, Iran
چکیده [English]

IntroductionHealth is one of the most important factors of human capital. Health affects labor supply both qualitatively (higher productivity) and quantitatively (not missing working days due to illness). Most countries have experienced a rapid growth in their health care costs in the past years.  But nfortunately, some countries still think that any activity in the field of improving health will increase costs It should be noted that the skilled workforce can be the focus of development and increase production when it has physical health and a cheerful spirit. Although health expenses and then human capital play a significant role in the development of societies, however, the factors affecting health expenses and the impact of each of its constituent factors have not been well investigated and analyzed.Therefore, according to the increasing growth of the expenses of this sector, it seems important to identify the components that affect the health expenses.Therefore, in order to properly plan in the health-economic fields, one should have a precise and accurate understanding of the factors affecting health expenditures.The same subject led the current research to investigate the comparative-comparative factors affecting private and public health care expenditures in selected developed and developing countries.
Methodology: This research used time series data for the period 2000-2019 and based on the panel data method, the variables affecting health expenditure for the private and public sectors of 15 selected developed countries including: Switzerland, Australia , Canada, Netherlands, Singapore, Germany, Sweden, Italy, USA, Norway, France, Japan, Denmark, Austria and Belgium; And also 15 selected developing countries including: Islamic Republic of Iran, Turkey, Georgia, Azerbaijan, China, Serbia, Ukraine, Peru, Lebanon, Panama, Albania, Armenia, Cuba, Mexico and Costa Rica will be analyzed and investigated. Variables of gross domestic product (GDP), life expectancy (EXP), population over 65 years old (POP), population under 14 years old (age), urbanization rate (URB), literacy rate (EDU), out-of-pocket payments (OOP) And foreign aid (ODA) is one of the influencing factors on health care expenses in this research. Also, the statistics and figures used in this research were extracted from the World Bank and the World Atlas (Knoema).
Results and Discussion: The variable coefficient of GDP, which is one of the effective variables in private and public health care expenditures in developed and developing countries, is positive and significant; the estimated coefficient of life expectancy variable is positive and significant.The impact of the variable population over 65 years old in developed and developing countries in both private and public sectors has been positive and significant.Also, the population under 14 years of age in both groups of developed and developing countries had a negative and significant relationship with health care expenditures in both private and public sectors;  Also, the variable impact of urbanization rate in developed and developing countries has been positive and significant in both private and public sectors;The effect of the out-of-pocket variable has been negative and significant in developed countries and positive and significant in developing countries .And the variable coefficient of foreign aid in developing countries is negative and significant. And finally, the results of this study showed that there is no significant statistical relationship between the literacy rate and health costs.
Conclusion: Considering the share of public and private sectors in health expenditures in developing countries, governments, as the largest public institution, should take the necessary measures to increase the share of public sector in health expenditures.

کلیدواژه‌ها [English]

  • Health economics
  • Health care expenditures
  • Developed and developing countries
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