典型发达国家的卫生筹资历史经验及对中国的启示——比较研究的视角

The historical experience of health financing in typical developed countries and its implications to China: A comparative study perspective

目的:基于历史比较的视角,总结典型发达国家的卫生筹资经验,为中国未来15年的卫生筹资提供参考借鉴。方法:采用层次聚类分析方法确定典型发达国家与中国2015—2030年经济社会发展水平类似的历史阶段;采用文献法梳理典型发达国家在类似阶段的卫生筹资经验和改革措施。结果:典型发达国家与中国2015—2030年类似的历史阶段大概在20世纪70年代中后期至21世纪初之间;在此期间,这些国家的卫生筹资经验主要集中在控制医疗费用和成本、完善卫生筹资政策和加强保障体系等方面。结论:类似历史阶段的提出为借鉴国际经验提供了新的思路与视角。借鉴典型发达国家的卫生筹资经验,结合中国实际,提出发展和完善多元化卫生筹资渠道,整合、健全健康保障制度和控制医疗费用过快增长的建议。

Objectives： The purpose of this study is to summarize the historical experience of health financing in typical developed countries, in order to provide reference for China＇s health financing over the next 15 years. Methods ： This paper uses hierarchical cluster analysis to determine the historical stage of typical developed countries similar to China in economic and social development from 2015 to 2030. Literature review is used to analyze the historical data and reform measures of health study found that the historical stage financing in typical developed countries during the similar stage. Results： The of typical developed countries that is similar to China in 2015--2030 is between the mid-or late-1970s and the beginning of the 21st century. During this period, typical developed countries mainly focused on controlling expenditures and costs, the experience of health financing in improving the health financing policy, strengthening the security system, etc. Conclusions： The similar stage research approach introduced in this paper provides a new idea and perspective to use the international experience for reference. Drawing lessons from the experience of health financing in typical developed countries combined with the Chinese context, this paper suggests the government should develop and improve diversified health financing channels, integrate and improve the health security system, and control the rapid escalation of health expenditure.