对 16 个国家的卫生系统绩效进行人口评估。

IF 8.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Bulletin of the World Health Organization Pub Date : 2024-07-01 Epub Date: 2024-04-30 DOI:10.2471/BLT.23.291184
Margaret E Kruk, Shalom Sabwa, Todd P Lewis, Ifeyinwa Aniebo, Catherine Arsenault, Susanne Carai, Patricia J Garcia, Ezequiel Garcia-Elorrio, Günther Fink, Munir Kassa, Sailesh Mohan, Mosa Moshabela, Juhwan Oh, Muhammad Ali Pate, Jacinta Nzinga
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引用次数: 0

摘要

目标:展示如何利用新的国际可比工具--人民心声调查,从民众的角度来评估各收入水平国家的医疗系统绩效:展示如何利用新的国际可比工具--"人民心声调查"(People's Voice Survey),在评估各收入水平国家的医疗系统绩效时从民众的角度出发:方法:我们对 16 个低收入、中等收入和高收入国家的代表性人口样本进行了调查,内容涉及 2022-2023 年期间的医疗保健使用情况、经验和信心。我们总结了与世界卫生组织全民医保框架关键领域相对应的数据,并将其可视化,用于卫生系统绩效评估。我们通过计算皮尔逊系数检验了与人均医疗支出的相关性,并使用不平等斜率指数检验了国家内部基于收入的不平等:在医疗效果方面,我们发现在健康检查和对公共初级医疗的认可方面存在很大差距。只有三分之一的受访者表示在就医过程中用户体验非常好,低收入国家的比例更低。在所有领域中,人们对医疗保健的可及性评价最高;然而,只有一半的人认为他们在生病时能够获得并负担得起高质量的医疗保健服务。在大多数国家,民众对私营医疗系统质量的评价高于公共医疗系统。只有一半的受访者认为自己参与了决策(高收入国家的比例较低)。在国家内部,我们发现许多指标在统计上存在明显的贫富不均:民众可以提供有关卫生系统实际功能的重要信息,补充其他系统绩效指标。人民心声调查 "等全人口调查应成为定期卫生系统绩效评估的一部分。
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Population assessment of health system performance in 16 countries.

Objective: To demonstrate how the new internationally comparable instrument, the People's Voice Survey, can be used to contribute the perspective of the population in assessing health system performance in countries of all levels of income.

Methods: We surveyed representative samples of populations in 16 low-, middle- and high-income countries on health-care utilization, experience and confidence during 2022-2023. We summarized and visualized data corresponding to the key domains of the World Health Organization universal health coverage framework for health system performance assessment. We examined correlation with per capita health spending by calculating Pearson coefficients, and within-country income-based inequities using the slope index of inequality.

Findings: In the domain of care effectiveness, we found major gaps in health screenings and endorsement of public primary care. Only one in three respondents reported very good user experience during health visits, with lower proportions in low-income countries. Access to health care was rated highest of all domains; however, only half of the populations felt secure that they could access and afford high-quality care if they became ill. Populations rated the quality of private health systems higher than that of public health systems in most countries. Only half of respondents felt involved in decision-making (less in high-income countries). Within countries, we found statistically significant pro-rich inequalities across many indicators.

Conclusion: Populations can provide vital information about the real-world function of health systems, complementing other system performance metrics. Population-wide surveys such as the People's Voice Survey should become part of regular health system performance assessments.

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来源期刊
Bulletin of the World Health Organization
Bulletin of the World Health Organization 医学-公共卫生、环境卫生与职业卫生
CiteScore
11.50
自引率
0.90%
发文量
317
审稿时长
3 months
期刊介绍: The Bulletin of the World Health Organization Journal Overview: Leading public health journal Peer-reviewed monthly journal Special focus on developing countries Global scope and authority Top public and environmental health journal Impact factor of 6.818 (2018), according to Web of Science ranking Audience: Essential reading for public health decision-makers and researchers Provides blend of research, well-informed opinion, and news
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