对中泰两国政府卫生投入差异的思考

Learning from the difference of government investment on health between Thailand and China

泰国和中国有相似的社会人口学状况和卫生服务提供体系,也同样面临卫生资源配置不平衡问题和推进全面医保的挑战。两国人均卫生总费用水平相似,但中国政府卫生支出占卫生费用比例及占财政支出比例均明显低于泰国;泰国政府卫生筹资职责主要由中央政府承担,而中国则在相当程度上依赖地方政府。通过对政府卫生支出总额和结构分析,发现中国卫生事业发展主要与地方经济有关,这一关联也导致了地区间资源分布的差异。

Thailand and China had similar demographic status and health service systems.Both were improving its universal coverage on the same challenge of the unbalanced health resources allocation among regions.China and Thailand had similar health expenditure per capita,but in China the share of both government health expenditure to total health expenditure and government health expenditure to total government expenditure were lower.Central government in Thailand took major responsibility of government health investment,but in China,most of government health investment came from local government,such as province and counties.Analysis of the amount and composition of government health expenditure shows that health sector development in China related largely to local economy and this relation led to inequity of health resources distribution among regions.