基于结构变动度的卫生总费用结构变动与优化路径研究

Research on Structural Changes and Optimization Paths of Total Health Costs Based on the Degree of Structural Changes

目的:分析卫生筹资和机构流向的总量和结构变动情况,找出其变化规律与特点,为安徽省医疗卫生资源的合理配置提供参考。方法:采用结构变动度的方法,从总量和结构两个层面对2006―2021年安徽省卫生费用的筹资及流向变化情况进行分析。结果:2006―2021年,安徽省卫生总费用逐年上升。筹资结构中政府卫生支出与社会卫生支出的变动值为正值,个人现金卫生支出的结构变动值为负值;从结构变动贡献率看,个人卫生支出贡献率率最大,为50%,社会卫生支出次之,政府卫生支出最小。流向结构中城市医院、卫生院、公共卫生机构的结构变动值为负值,县医院和社区卫生中心结构变动值为正值。结论:2006―2021年安徽省卫生总费用规模呈增长趋势,筹资结构逐渐优化,个人医疗负担进一步减轻。公共卫生机构和基层医疗卫生机构资源配置仍有完善提升的空间。

Objective To analyze the total amount and structural changes of health financing and institutional flow,find out its changing rules and characteristics,and provide reference for the rational allocation of medical and health resources in Anhui Province.Methods Using the method of structural change degree,the changes of financing and flow direction of health expenditure in Anhui Province from 2006 to 2021 were analyzed from two aspects of total amount and structure.Results From 2006 to 2021,the total health expenditure in Anhui Province maintained an increasing trend.In the financing structure,the change value of government health expenditure and social health expenditure is positive,and the change value of personal cash health expenditure is negative.The structural change value of urban hospitals,health centers and public health institutions in the flow structure is negative,and the structural change value of county hospitals and community health centers is positive.Conclusion From 2006 to 2021,the scale of total health expenditure in Anhui Province showed an increasing trend,the financing structure was gradually optimized,and the personal medical burden was further reduced.The resource allocation of public health institutions and primary health care institutions is insufficient.