撒哈拉以南非洲的公共卫生支出:利用潜在增长曲线中介模型探索传播机制。

IF 2.7 3区 经济学 Q1 ECONOMICS Health Economics Review Pub Date : 2024-02-19 DOI:10.1186/s13561-023-00472-5
Wa Ntita Serge Kabongo, Josue Mbonigaba
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引用次数: 0

摘要

为了应对全民医保的迫切需要,撒哈拉以南非洲地区(SSA)需要关注可能阻碍增加支出效果的结构性因素。本研究评估了这些因素在国内一般政府卫生支出(DGGHE)效应中的中介作用,以提出改善人口健康结果(PHO)的解决方案。分析采用了结构方程模型(SEM)框架内的潜在增长曲线中介模型(LGCMM)方法,对来自 42 个 SSA 国家 2015 年至 2018 年的面板数据进行了分析。研究结果表明,疟疾和女性教育构成了DGGHE对SSA国家DALY产生影响的渠道,这些影响是通过DGGHE斜率到DALY斜率的特定路径,通过疟疾和女性教育斜率实现的。然而,论文没有发现免疫接种覆盖率对撒哈拉以南非洲地区的 DGGHE 和 DALY 之间的关系起中介作用的证据。本文的结论是,结构性因素影响了 DGGHE 对 PHO 的有效性,这意味着政府应重视现有的抗击疟疾和提高免疫覆盖率的计划。
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Public health spending in Sub-Saharan Africa: exploring transmission mechanisms using the latent growth curve mediation model.

In response to the imperatives of universal health coverage, structural factors that may hinder the effectiveness of increased spending in sub-Saharan Africa (SSA) need attention. This study assessed the mediating role of these factors in domestic general government health expenditure (DGGHE) effects to propose solutions for improving population health outcomes (PHO). The analysis used the Latent Growth Curve Mediation Model (LGCMM) approach within the structural equation model (SEM) framework for panel data from 42 SSA countries from 2015 to 2018. The findings were that malaria and female education formed a channel through which DGGHE imparted its effects on DALY in SSA, and these effects were achieved via the specific path from the DGGHE slope to the DALY slope, via malaria and female education slopes. However, the paper found no evidence of immunization coverage mediating the relationship between DGGHE and DALY in SSA. The paper concludes that structural factors affect the effectiveness of DGGHE on PHO, implying that governments should emphasize existing programs to fight against malaria and increase immunization coverage.

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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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