卫生筹资与卫生系统绩效之间的关系及对中国的启示研究

A Study on the Relationship Between Health Financing and Health System Performance

目的:探索卫生筹资对卫生系统绩效的影响,为筹资模式的设计提供依据。方法:以经济合作发展组织(OECD)29个国家为研究样本,将其筹资模式分为税收与社会保险筹资两种方式,采用多元线性回归模型,构建卫生筹资模式及有关变量与卫生系统绩效间的回归模型。结果:税收筹资模式国家的卫生系统绩效总体优于社会保险模式的国家。政府卫生投入、卫生支出、GDP等筹资指标与卫生系统绩效正向相关。结论:税收筹资模式能更好地改善卫生系统绩效。中国卫生筹资应优先考虑税收筹资制度。

Objective： The purpose of this study is to explore the quantitative relationship between health financing and health system performance and to find out the better financing model. Methods： Twenty nine OECD countries were selected as the sample and they were grouped into two categories as tax and social-insurance financing model. Multiple-regression was used to construct the relationship between health financing and health system performance. Results： The model showed that the general-tax financing model was better than social health insurance model in term of health system performance in OECD countries. The government health expenditures and the proportion of total health expenditure to GDP positively related with health system performance. Conclusions： The general-tax financing model is superior to social health insurance model in term of improving health system performance. China should select the general-tax financing model as the first choice in designing the health system.