发展中国家经济发展对全民健康及医疗保障制度的影响

The Impact of Developing Country Economic Development on the National Health and Health Care System

目的:探讨发展中国家经济发展对全民健康及医疗保障制度的影响。方法:对10个发展中国家2003—2011年的经济、健康官方数据进行回顾性统计描述,并用Spearman秩相关分析经济和健康及医疗保障制度各重要指标相关性。结果:2003—2007、2008—2011年间,人均GDP和期望寿命的相关系数分别0.845(P=0.004)、0.728(P=0.026),基尼指数和医疗卫生总支出占GDP百分比的相关系数分别为0.936(P<0.001)、0.817(P=0.007),贫富差距比和医疗卫生总支出占GDP百分比的相关系数分别为0.948(P<0.001)、0.733(P=0.025)。结论:发展中国家人民健康水平和医疗保障制度的分配主要还是与经济发展指标(GDP)存在一定联系,而与经济不平等性关联较弱。发展中国家要提高人民健康水平和医疗保健制度完善性,一定时期内还要靠经济拉动。同时注重社会财富再分配,缩小贫富差距,提高医疗卫生服务公平性。

Objective： To explore the impact of economic development on the national health and medical insurance system. Methods： The regression calculation description were processed on the economic and health public data of 10 developing countries, Spearman rank correlation were used to analyze important indexes of economic, health and medical insurance system. Results： During 2003-2007 and 2008-2011, the correlation coefficient between the GDP per capita and life expectancy are 0.845（P=0.004） and 0.728 （P=0.026）. The correlation coefficient for the percent of Gini index and health expenditure in GDP were 0.936（P〈0.001） and 0.817（P= 0.007）. The correlation coefficient for the percent of the gap between rich and poor and medical health expenditure in GDP were 0.948 （P〈0.001） and 0.733（P=0.025）. Conclusion： People＇s health level and the distribution of health care system have a major relation with the standards of the development of economy（GDP）, while they are related to the economic inequality infirmly. Over a period of time, the developing countries need to rely on the economy to improve human health level and the completeness of the health care system. At the same time, it needs to pay attention to the redistribution of social wealth, narrow the gap between rich and poor and improve the fairness of medical and health services.