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首页> 外文期刊>Journal of public health management and practice: JPHMP >The Problem With Estimating Public Health Spending
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The Problem With Estimating Public Health Spending

机译：估计公共卫生支出的问题

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Accurate information on how much the United States spends on public health is critical. These estimates affect planning efforts; reflect the value society places on the public health enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic public health finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national public health finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of public health activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on public health ($200 per capita on average, median $166). Census public health data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria-most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to meaningfully systematize reporting of public health spending and revenue.
机译：关于美国在公共卫生上花费多少的准确信息至关重要。这些估计会影响计划工作;反映社会对公共卫生事业的重视;并可以证明旨在提高人口健康水平的计划，政策和服务的成本效益。但是，目前，系统的公共卫生财政数据来源有限。由于不同的原因，以不同的方式收集这些来源中的每一个，因此产生的结果也截然不同。本文旨在比较和对比所有当前的四个国家公共卫生财务数据集，包括由美国卫生信托，州和地区卫生官员协会（ASTHO），全国县市卫生官员协会（NACCHO）汇编的数据以及人口普查，这些数据经常被引用为国家卫生支出帐户对公共卫生活动的估算。在2008财政年度，ASTHO估计州卫生机构花费了240亿美元（人均94美元，中位数为79美元），而人口普查估计，包括州卫生机构在内的所有州政府机构在公共卫生上的支出为600亿美元（人均200美元，中位数为166美元） ）。人口普查公共卫生数据表明，地方政府的人均支出为87美元（中位数为57美元），而NACCHO估计，报告的LHD在2008财年的人均支出为64美元（中位数为36美元）。我们得出的结论是，这些估算值之所以有所不同，是因为各个组织使用不同的手段，数据定义和纳入/排除标准来收集数据，尤其是围绕是否包括所有机构与州/地方卫生部门的支出以及行为健康，残疾，估算中包括一些临床护理支出。除了对目前未充分利用的人口普查行政数据进行更深入的分析之外，我们还看到了协调工作和建立标准化的支出报告系统，以此作为对公共卫生支出和收入的报告进行有意义的系统化的一种方式。

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