国际视角剖析中国卫生总费用筹资结构的“适宜性”

A study on the appropriate structure of total health expenditure from international angle

随着近年来医疗服务体系"看病贵"呼声愈演愈烈,卫生总费用中个人负担比例是否合理一直困扰各方。文章为确定"适宜"的个人筹资比例,在综合文献和WHO报告的基础上,以卫生总费用中个人支出比例作为因变量,经济、健康、政府对卫生重视程度和居民的生活消费水平(负担水平)为自变量建立Panel data模型,发现:从先进国家的经验角度上,2020年中国卫生总费用中个人支出比例的"适宜"数值应在30%左右的区间。然而,为了实现卫生总费用合理的筹资结构,不仅需要政府、社会和个人的努力,还需要医院、药品供应保障、医疗保障等各方的博弈,只有达到共赢,才能实现中国就医环境的真正改善。

With the intensified public voice ＂expensive medical cost＂ on the medical service system in recent years,whether the individual payout is reasonable has plagued the people,government and researchers. To make clear the ＂appropriate＂ individual payout,based on the literature reviews and the WHO reports,the study analyzes the data from two aspects： 191 WHO member states and 76 superior states（the health performance is better than that of China） by using the Panel data model. The dependent variable is individual payout. And the independents are economy,health,the government emphasis on the health and consumption level of residents. The results show：Chinese appropriate individual payout intervals are respectively around 30% from the WHO angle and the superior state angle in 2020. For the realization of the feasible structure of total health expenditure,we not only need the efforts from government,society and individual,but also need the cooperation among hospitals,drug supply security system,health care system and other health systems. Only achieve win-win situation,the Chinese health environment can be improved.