Why have patterns of healthcare spending varied during the Great Recession? Using cross-national, harmonized data for 27 EU countries from 1995 to 2011, we evaluated political, economic, and health system deter-minants of recent changes to healthcare expenditure. Data from Euro Stat, the IMF, and World Bank (2013 editions) were evaluated using multivariate random-and fixed-effects models, correcting for pre-existing time-trends. Reductions in government health expenditure were not significantly associated with magnitude of economic recessions. Nor did ideology of governing parties have an effect. In contrast, each $100 reduction in tax revenue was associated with a$2. 72 drop in health spending. IMF borrowers were significantly more likely to reduce healthcare budgets than non-IMF borrowers, even after correcting for potential confounding by indication. Exposure to lending from international financial institutions, tax revenue falls, and decisions to implement cuts correlate more closely than underlying eco-nomic conditions or orientation of political parties with healthcare expenditure change in EU member states.%在经济衰退期间卫生支出为何呈现出多样化？本文采用1995-2011年27个欧洲国家的数据，对可能引起卫生支出变化的政治、经济和卫生体系等关键因素进行评估。纠正之前存在的时间趋势，采用随机效应模型和固定效应模型对2013年欧盟统计局、国际货币基金组织和世界银行的数据进行了测量和评估。研究发现，政府卫生支出的削减与经济衰退的程度关系不大；执政党的意识形态也不会对政府卫生支出产生很大影响。相反，税收每减少100美元，卫生支出将减少2．72美元。在控制可能的混淆因素后，国际货币基金组织贷款国家比非贷款国家更有可能削减政府卫生支出。在欧盟成员国中，与经济条件和政党意识形态等因素相比，向国际金融机构贷款、税收减少以及实施削减政策等可能更会导致政府卫生支出的削减。
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