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首页> 外文学位 >Health services research in the era of new welfare state theories: Political, welfare state, and health care determinants of population health in wealthy countries.
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Health services research in the era of new welfare state theories: Political, welfare state, and health care determinants of population health in wealthy countries.

机译：新福利国家理论时代的卫生服务研究：富裕国家人口健康的政治，福利国家和医疗保健决定因素。

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摘要

I investigate the political, welfare-state, and health system pathways through which macro-level political economic factors affect population health using macro-comparative analytical techniques. I study the health effects of the political power and ideologies that enabled the establishment of welfare and health care systems, as well as the relationship between health services and welfare state are studied. Main data sources include the Comparative Welfare State Dataset and the OECD Health Data 2000 and 2006 for the period of 1960 to 2000 (41 years) in 19 wealthy countries. Low birth weight and infant mortality rate are outcome variables.;Multilevel analyses testing whether welfare state regime type affects population health status revealed that Social Democracies as a group show significantly better population health status compared to other countries. Next, multivariate regressions, incorporating political power, welfare state, and health services indicators, were conducted to explain observed health status differences among welfare state regimes. While political and welfare state determinants are significantly associated with population health, the more proximal health care variables (i.e., public medical coverage) better predict population health status.;The interplay between welfare state and health services decommodification and universalism, and the effect of the US as a statistical outlier are investigated in last analyses. Bivariate regressions with a multiple imputed dataset revealed that the statistically significant correlation between the percentage of public medical coverage and health outcomes is largely due to the inclusion of the US, but that the explanatory power of political power, welfare state score and welfare state regime types remain stable.;As a conclusion, I propose a concept of "welfare-health care mix," which claims that population health status can only be predicted through an integral understanding of the unique mixture of the welfare state and health care arrangements of a country. To achieve a further improvement in population health status, health services research in the 21 st century should focus on wider contextual determinants of population health including welfare state and labor policy, at the same time defending or improving the current status of public health care services.
机译：我使用宏观比较分析技术研究了宏观政治经济因素影响人口健康的政治，福利国家和卫生系统途径。我研究了政治力量和意识形态对健康的影响，这些政治力量和意识形态使福利和医疗体系得以建立，并研究了卫生服务与福利国家之间的关系。主要数据来源包括19个富裕国家1960年至2000年（41年）期间的比较福利国家数据集和OECD 2000和2006年健康数据。低出生体重和婴儿死亡率是结果变量。多层次分析测试福利状态制度类型是否影响人口健康状况显示，与其他国家相比，社会民主主义国家整体显示出明显更好的人口健康状况。接下来，进行了包含政治权力，福利状态和卫生服务指标的多元回归，以解释观察到的福利状态制度之间的健康状况差异。尽管政治和福利国家决定因素与人口健康显着相关，但更接近的医疗保健变量（即公共医疗覆盖率）可以更好地预测人口健康状况。;福利国家与医疗服务商品化和普遍主义之间的相互作用以及在最后的分析中对美国作为统计异常值进行了研究。具有多元估算数据集的双变量回归显示，公共医疗覆盖率与健康结果之间的统计显着相关性很大程度上归因于美国的加入，但政治权力，福利国家得分和福利国家制度类型的解释力最后，我提出了“福利-保健混合”概念，该概念声称只能通过对一个国家的福利国家和保健安排的独特组合的整体理解来预测人口健康状况。为了进一步改善人口健康状况，二十一世纪的卫生服务研究应着眼于更广泛的人口健康环境决定因素，包括福利国家和劳工政策，同时捍卫或改善公共卫生服务的当前状况。

著录项

  • 作者

    Chung, Haejoo.;

  • 作者单位

    The Johns Hopkins University.;

  • 授予单位 The Johns Hopkins University.;
  • 学科 Health Sciences Public Health.;Sociology Public and Social Welfare.
  • 学位 Ph.D.
  • 年度 2007
  • 页码 182 p.
  • 总页数 182
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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