基于省际视角的我国卫生筹资结构空间分布研究

Spatial Distribution Study of Health Financing Structure in China Based on the Provincial Perspective

目的:从时间和空间角度分析新医改以来我国卫生筹资结构状况。方法:分析我国卫生筹资结构的纵向变化情况,同时运用Arc Gis 10.0软件对31个省份的卫生筹资结构数据进行空间自相关分析。结果:各省份卫生事业投入适度增长,筹资结构得到优化,但地区差异依旧明显,投入结构还不尽合理;2011—2013年政府卫生支出和2013年社会卫生支出占卫生总费用的比重存在空间集聚特征;局部自相关分析显示,个人和社会卫生支出比重"热点"区域集中于东部,政府卫生支出比重"热点"区域集中于中西部。结论:在保证卫生投入总量的基础上深入优化卫生筹资结构,提高政府卫生投入,降低个人现金负担;关注卫生筹资结构的地域差异性和聚集性,各地区需要结合卫生事业发展大局和本地特点,探寻符合本地实际的卫生筹资结构,优化筹资方式。

Objective： To analyze the structure of Total Expenditure on Health（TEH） of China.since the new medical reform from the time and spatial perspective. Methods： The longitudinal changes of China TEH structure was analyzed. The spatial autocorrelation analysis was performed on the TEH data of 31 provinces by ArcGis 10.0 Software. Results： Each province had a modest increase on health expenditure, and their structures were also gradually optimized, but they still had evident regional differences, and their expenditure structure was not completely rational. The proportions of 2011-2013 year＇s government health expenditure and 2013 year＇s social health expenditure in TEH had spatial aggregation characteristics. Local autocorrelation analysis showed that, the proportions of personal and social health expenditure had ＂hotspot＂ as mainly in the east, while government health expenditure proportions had hotspots mainly in the midwest. Conclusion： Based on guarantying the THE, it needed to improve government health input, decrease individual cash burden; pay attention to the geographical differences and aggregation of health financing structure, combine health business development and local characteristics, explore health financing structure suitable for actual local situation and optimize financing method.