Author
Listed:
- Mehdi Ammi
- Raphael Langevin
- Erin C. Strumpf
- Emmanuelle Arpin
Abstract
Epidemiological crises such as the COVID-19 pandemic affect healthcare systems in many ways. In Quebec, as elsewhere, this kind of major event may have influenced both total public health spending and its distribution between the various public health functions. It is therefore essential to better understand the decisions and trade-offs in the allocation of expenditures between major public health functions, and to better understand the consequences of the choices that are made. This report provides an opportunity to improve our understanding of these issues. The analyses are based on sophisticated econometric approaches and several sources of population health, demographic and socioeconomic data, as well as epidemiological data on COVID-19 per region and from the open dataset available from the Quebec Data Partnership and the INSPQ. The authors show that the pandemic led to a reallocation of funds, with some expenditure items being prioritized at the expense of others. Expenditures on population health monitoring, health promotion, disease prevention and Sexually transmitted and blood-borne infections (STBBIs) have all decreased compared to what would have been spent in these categories in the absence of a pandemic. The authors suggest that reduced spending on healthy living and mental health, which are part of health promotion and disease prevention, may have resulted in deleterious effects on population health. Les crises épidémiologiques comme celle de la pandémie de COVID-19 affectent les systèmes de santé dans de multiples dimensions. Au Québec comme ailleurs, ce genre d'événement majeur peut avoir influencé non seulement les dépenses totales en santé publique, mais aussi leur répartition entre les différentes fonctions de santé publique. Il est donc primordial de mieux comprendre les décisions et arbitrages dans l’allocation des dépenses entre les grandes fonctions de santé publique et aussi mieux comprendre les conséquences des choix qui sont faits. Ce rapport permet précisément d’améliorer notre compréhension de ces questions. Les analyses s’appuient sur des approches économétriques complexes et sur plusieurs sources de données de santé populationnelle, démographiques et socioéconomiques, et sur des données épidémiologiques de la COVID-19 par région et provenant du jeu de données ouvertes disponibles du Partenariat Données Québec et de l’INSPQ. Les auteurs montrent que la pandémie a conduit à une réallocation des sommes en privilégiant certains postes de dépenses aux dépens d'autres. Les dépenses en surveillance de la santé des populations, en promotion de la santé, en prévention des maladies et celles pour la lutte aux Infections transmissibles sexuellement et par le sang (ITSS) ont toutes baissé comparativement aux prévisions de ce qu’auraient été les dépenses dans ces catégories en l’absence de pandémie. Les auteurs suggèrent que la réduction des dépenses en promotion des saines habitudes de vie et en bonne santé mentale, lesquelles font partie des actions de promotion de la santé et de la prévention des maladies, pourrait avoir entrainé des effets délétères sur la santé des populations.
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