我国卫生总费用影响因素通径分析

Path analysis for influencing factors of the total health expenditure of China

目的研究卫生总费用的影响因素,为控制医疗费用合理增长提供科学依据。方法对1990-2012年卫生总费用及有关影响因素数据进行通径分析。结果国内生产总值(GDP)、城镇人口比重、个人卫生费用支出比例直接影响卫生总费用(P<0.01)。政府卫生支出占政府财政支出的比例对卫生总费用的影响,不仅存在直接效应,而且存在间接效应。年末总人口数、65岁以上人口数和人均GDP通过GDP间接影响卫生总费用。结论宏观经济发展状况是直接影响卫生总费用的最主要因素,城镇化和人口老龄化对卫生总费用发挥明显的推动作用。应采取有效措施控制卫生总费用的合理增长,城镇化和老龄化进程中应注重解决农村卫生服务的供给问题,做好老年人医疗卫生保障工作。

Objective To investigate the influencing factors of the total health expenditure（ THE） of China. Methods Through path analysis model,we analyzed the data of THE from 1990 to 2012 and its influencing factors in China.Results The gross domestic production（ GDP）,the proportion of urban population and the proportion of personal health expenditure had direct influence on THE（ P〈0. 01）. The proportion of government health expenditure to total government expenditure had both direct and indirect influence on THE. Conclusion Development of national economy is the most important factor affecting THE. Urbanization and population aging are playing more and more significant roles in promoting the growth of THE. Effective measures should be taken to control the growth of THE and more works are needed to focus on providing health care for rural residents and providing health care for aging population in the urbanization and population aging process.