中国卫生财政研究60年文献述评

Literature Review on 60 Years' Health Care Fiscal Research for China

医疗卫生筹资问题是医药卫生体制改革与卫生政策总体框架设计中的基本问题,而钱的"性质"则是当前医药卫生体制改革的核心问题。卫生事业的福利性质决定政府应该为医疗卫生服务承担应有的责任与义务。中国卫生财政研究历史可划分为1949—1978年、1979—2008年和2008年至今三个阶段。研究内容主要包括:卫生财政预算、卫生财政支出规模、公共卫生财政、医疗财政、城乡初级卫生保健财政、卫生财政支出方式和卫生财政支出绩效七大部分。虽然,目前针对卫生财政议题的研究较多,但研究内容比较零散,未形成研究体系。未来应该着重对国际医疗卫生财政,临床医疗、公共卫生、卫生保健服务与公共财政体制、公共财政支出结构的基础性理论政策议题,以及卫生财政与各级政府间财政关系三大类议题展开研究。

Medical and health financing was the basic issue in medical and health system reform and the design of the overallframework of health policy. The'nature'of money was the core issue in the current medical and health mechanism reform. The wel-fare nature of health determined that the government should shoulder the responsibility of medical and health services. The history ofChinese health fiscal research could be divided into three stages:1949-1978,1979-2008 and 2008 till now. Research contents cov-ered health care fiscal budget, health care fiscal expenditure scale, public health fiscal, medical fiscal, urban and rural primaryhealth care fiscal,health fiscal payment methods and health fiscal expenditure performance. Although many researches on health fis-cal issue existed, there was no uniform research system. Researchers should focus on the issues of international medical and healthfiscal,basic theoretical policy issues of clinical medicine,public health,health care services and public fiscal system,public fis-cal expenditure structures and the fiscal relationship among health fiscal and each level government.