我国卫生总费用筹资的结构性特征与人均可支配收入的比较分析

Comparative analysis of the structural characteristics of total health expenditure financing and the per capita disposable income in China

本文依据我国2003—2015年卫生总费用的基础数据,比较新医改前后卫生总费用筹资的结构性特征与人均可支配收入的变化,分析了新医改前后卫生总费用筹资的总体水平、筹资结构变化的合理性、总体发展趋势的可持续性及其与人均可支配收入的发展变动特征。研究发现,新医改之后我国卫生总费用增长率虽有所下降,但个人卫生支出增长率仍呈上升趋势,政府医疗保障支出的增长对个人卫生支出的替代水平有限,人均个人卫生支出增长率超过城乡居民人均收入增长率,"看病贵"问题仍然非常突出。针对以上问题,本文提出加快公立医院改革,强化医保基金专业化建设,提高医保基金控费能力等建议。

Based on the basic data of China＇s total health expenditure from 2003 to 2015, this paper compares and analyze the structural characteristics of total health expenditure financing and the per capita disposable income before and after the new health care reform, in order to understand the overall level of total health expenditure finan- cing before and after the new health care reform, whether the financing structural changes is reasonable and the over-all trend is sustainability, and the relationship of the changes between per capita disposable income and health expenditure. The study found that, 1 ） although the growth rate of total health expenditure in China has declined after the new health care reform, the growth rate of personal health expenditure is still on the rise; 2） the growth rate of government health insurance expenditure is limited to the substitution of personal health expenditure, and the growth rate of per capita personal health expenditure is still higher than the growth rate of urban and rural residents＇ per capita income ; 3 ） the problem of residents＇ serious burden of medical treatment is still very prominent. Based on the above problems, this paper accordingly proposes to speed up the reform of public hospitals, strengthen the construction of medical insurance fund specialization, and improve the ability of medical insurance fund to control costs, etc.