(Reuters) – Reallocation of government funds from health care spending to social service spending could improve the health of the population, a new study suggests.
Canadian researchers analyzed data collected between 1981 and 2011 from nine provinces and calculated average health care expenditures and average social service expenditures for each of the 31 years. Then they looked at trends over time, to see what type of spending was more positively associated with health outcomes.
Overall, as reported online January 22 in CMAJ, results showed that average per-capita spending on health care was more than three times higher than per-capita spending on social services.
And while social spending was positively associated with population health measures, health care spending did not show this same association. Specifically, according to the paper, a one-cent increase in social spending per dollar spent on social services was associated with a 0.1% decrease in avoidable mortality and a 0.01% increase in life expectancy.
In simpler terms, “this means that a 10-cent increase in social services per dollar spent on health care might reduce three deaths per 100,000 over a year’s time,” said Elizabeth Bradley, a health policy and health economics researcher and the president of Vassar College in Poughkeepsie, New York, in email to Reuters Health.
“We keep spending more and more on health care over time because, in part, the rhetoric around the health of the population has centered on the health care system,” said lead study author Daniel Dutton of the University of Calgary in an email.
Government funds intended to improve population health are divided into two categories: health care and social services. Most governments allocate more funds toward running the health care system.
“Health care spending is spending on medical services – payments made to hospitals, doctors, and other health care providers,” Amanda Brewster from Yale University’s School of Public Health in New Haven, Connecticut, told Reuters Health by email.
Social services spending, on the other hand, goes toward programs that individuals have little control over. Such services are designed to address so-called “social determinants” of health where people live and work.
“Spending on social services covers a wide variety of other types of services that generally support well-being in other domains of life . . . which may include education, income support, poverty-reduction programs, subsidized housing and nutrition programs,” said Brewster.
Previous analyses of international data suggest that an exclusive focus on health care spending is misleading, the authors write. They say a shift toward spending on social services could contribute to the long-term goal of creating an environment based on prevention rather than management – without increasing the overall federal budget.
“Health care providers are increasingly recognizing that addressing underlying social issues is crucial to helping patients recover from illness,” says Brewster. “For example, finding transportation for a patient who lacks a car to get to medical appointments or identifying a source of healthy food for a patient who needs to be on a particular type of diet. These types of social issues lie outside the historical purview of the health care system though, so addressing them requires collaboration between health care organizations and social services agencies.”
SOURCE: http://bit.ly/2GtiinC
CMAJ 2018.
Tidak ada komentar:
Posting Komentar