中等以上收入国家卫生资源在人均GDP与婴儿死亡率间的中介路径

The Mediating Pathways of Health Resources in the Association between Per Capita GDP and Infant Mortality Rate in High- and Middle-Income Countries

摘要: 目的：分析人均GDP通过相关卫生资源因素影响婴儿死亡率的间接效应。方法：基于世界银行数据库的更新数据，以高和中等收入国家的婴儿死亡率为因变量，人均GDP为自变量，分别以护士和助产士(每千人)、熟练医护人员护理下分娩(%)、医院床位(每千人)为中介变量，进行中介效应分析。结果：护理人力(护士和助产士)在高收入国家发挥部分中介作用，但在中等收入国家中介效应不显著；分娩服务(熟练医护人员护理下分娩)在高和中等收入国家均发挥部分中介作用；而硬件资源(医院床位)在高收入国家表现为遮掩效应，在中等收入国家中介作用亦不显著。结论：在不同经济发展阶段，人均GDP通过卫生资源间接影响婴儿死亡率的中介路径存在显著的异质性，仍需不断积累数据深入探索。

Abstract: Objective: This paper aims to analyze the indirect effect of per capita GDP on infant mortality rate through relevant health resource factors. Method: Based on updated data from the World Bank database, a mediation analysis was conducted with infant mortality rate in high- and middle-income countries as the dependent variable, per capita GDP as the independent variable, and nurses and midwives (per 1000 people), deliveries attended by skilled health personnel (%), and hospital beds (per 1000 people) as mediating variables. Results: Nursing human resources (nurses and midwives) played a partial mediating role in high-income countries, but the mediating effect was not significant in middle-income countries. Delivery services (deliveries attended by skilled health personnel) played a partial mediating role in both high- and middle-income countries. However, hardware resources (hospital beds) exhibited a masking effect in high-income countries, while the mediating effect was not significant in middle-income countries. Conclusion: At different stages of economic development, the mediating pathways through which per capita GDP indirectly affects infant mortality via health resources exhibit significant heterogeneity. Further data accumulation is still needed for in-depth exploration.