我国政府卫生支出地区公平性研究

Study on regional equity of government health expenditure in China

目的:本文从均等化的视角分析我国近年来政府卫生支出的地区差异及其变化。方法:计算近10年来各省间和东、中、西部地区政府卫生支出的基尼系数和泰尔指数,并分析历年变化及原因。结果:基尼系数从2003年的0.31下降至2013年的0.11;泰尔指数从2003年的0.027 0下降至2013年的0.000 4,其中2011年及2012年有所反弹。东部地区泰尔指数由正转为负,其优势逐渐转为劣势;中部地区泰尔指数为负值但向0靠近,处于劣势但有所改善;西部地区2006年以前泰尔指数为负,但2009年以后为正,其相对劣势逐渐转化为相对优势。结论:近年来由于公共卫生服务均等化政策实施,各省间政府卫生支出的整体公平性上升,东高、中低、西较低的格局有所变化。建议:中央财政转移支付应适当增加河北、山东、广东、湖南及河南等人口大省的政府公共卫生投入。

Objective： This article is to calculate and analyze the equalization of government health expenditure inof different provinces and areas in the past decade. Methods： To calculate the Gini Coefficient and Theil Index in of different provinces and areas for government health expenditure in the past decade,and to explore potential reasons..Results： The Gini Coefficient declined substantially in the past years,which decreased from 0. 31 in 2003 to 0. 11 in2013. The Theil Index declined substantially in the past years,which decreased from 0. 0270 in 2003 to 0. 0004 in2013. Eastern provinces were in advantaged positions in the past decade but the degree of advantage was declining,central provinces were in disadvantaged positions in the past decade but the degree of disadvantage was declining,while western provinces were in relatively disadvantaged positions before 2006 but became advantaged since 2009.Conclusions： The regional equity of government health expenditure for different provinces and areas has been improved in the past decade especially for implementing the equalization of public health policy. Recommendations：The central government of China should increase transfer payment into some provinces with of large population like Hebei,Shandong,Guangdong,Hunan and Henan to increase the regional equity of government health expenditure.