政府卫生支出对中国农村居民健康的影响

Effects of the Government's Health Expenditure on the Health of Rural Residents in China

依据全国30省"千村"现场调查数据,采用国际通用健康SF—8量表的自测健康,运用Grossman理论的扩展模型和顺序概率回归方法,分析公共卫生、基本医疗服务可及性和新农合对居民健康的影响,结果表明:村卫生室诊疗水平对生理健康影响非常显著,对心理健康没有影响;与最近医疗机构的距离和污水排放系统,对所有健康指标均有非常显著影响;饮用自来水对健康有正面影响;新农合筹资水平对居民健康没有影响,其效果主要表现在减少大病患者个人经济风险和促进社会和谐。年龄、教育水平等个人因素对健康有显著影响。研究结果支持政府农村卫生支出重点投向基层医疗服务和公共卫生的发展策略,验证了新农合的目标主要就是化解重大疾病的经济风险。

Based on a nationwide field survey ofa thousand villages'in 30Chinese provinces, this study employs the SF-8global health status measure and the extended model of Grossman and its sequential probability regression to analyze the effects of public health,the access of basic medical services and the new rural cooperative medical system on the health of residents.The results show that the diagnostic and treatment level of village clinics has a marked effect on residents'physiological health but no effect on their mental health;the distance from the nearest medical institution and the sewage discharge system have a fairly noticeable effect on all health indicators;drinking tap water has a positive effect on health;and the fund-raising level of the new rural cooperative medical system has little effect on the health of residents,with its effect typically seen in reducing the individual economic risks of patients with serious diseases and promoting social harmony.Age,educational level and other individual factors have a remarkable effect on health.Our research supports the government's development policy of placing the emphasis of rural health expenditure on grassroots medical services and public health,and verifies that the goal of the new cooperative scheme is to eliminate the economic risks of catastrophic diseases.