摘要
目的探讨我国卫生费用和社区卫生服务发展现状,进一步分析社区卫生服务的发展对合理控制卫生费用的作用。方法以2015年《中国卫生总费用研究报告》、1978—2013年《中国卫生统计年鉴》以及2014—2016年《中国卫生和计划生育统计年鉴》为资料来源,收集我国近些年卫生总费用、社区卫生服务机构卫生费用、机构数、人力资源配置情况、收入情况、服务人次等情况,分析我国卫生费用及社区卫生服务发展现状。结果 1978—2015年,我国卫生费用支出由110.21亿元上升至40 974.64亿元,增加了40 864.43亿元,年均增长率为17.35%。2005—2014年,我国卫生总费用、社区卫生服务中心卫生费用分别从9 204.14、72.53亿元增至36 824.98、877.52亿元,分别增加了27 620.84、804.99亿元,年均增长率分别为16.66%、31.92%;社区卫生服务中心卫生费用占比从0.79%增至2.38%,增加了1.59个百分点。2010—2015年,我国全国社区卫生服务机构数从32 739个增至34 321个,增加了1 582个,年均增长率为0.95%。2010—2015年,我国全国社区卫生服务机构人员总数、注册护士、执业医师、卫生技术人员数分别从389 516、106 528、144 225、331 322名增至504 817、153 393、181 670、431 158名,增加了115 301、46 865、37 445、99 836名,年均增长率分别为5.32%、7.56%、4.72%、5.41%。2010—2015年,我国全国社区卫生服务机构总收入从805.4万元增长至1 337.1万元,增加了531.7万元,年均增长率为10.67%。2010—2015年,我国全国社区卫生服务机构门急诊人次、住院人次从34 740.4、218.1万人次增长至55 902.6、305.5万人次,分别增加了21 162.2、87.4万人次,年均增长率为9.98%、6.97%;在所有医疗机构急诊人次、住院人次数的占比分别从9.6%、5.5%增加至12.9%、7.6%,分别增加了3.3、2.1个百分点。结论我国卫生费用大幅增长,社区卫生服务发展迅速,社区卫生服务卫生费用在卫生总费用中的比重增加,社区卫生服务发展是合理控制卫生费用的有效途径之一。
Objective To explore the status of community health services development and the national healthcare expenditure in China,and to analyze the role of the former in reasonably controlling healthcare expenditure growth.Methods We collected the data concerning the annual total national healthcare expenditure,annual total healthcare expenditure,number,manpower configuration,annual total healthcare revenue,and number of services of community health centers(CHCs)in China in recent years from China National Health Accounts Report(2015),36 volumes of China's Health Statistical Yearbook(1978—2013) and 3 volumes of China's Health And Family Planning Statistical Yearbook(2014—2016) and analyzed the status of total national healthcare expenditure and community health service development.Results From 1978 to 2015,the total national healthcare expenditure increased to 4.097 464 trillion yuan from 11.021 billion yuan,with an increase of 4.086 443 trillion yuan and an average annual growth rate of 17.35%.From 2005 to 2014,the total national healthcare expenditure increased to 3.682 498 trillion yuan from 920.414 billion yuan,with an increase of 2.762 084 trillion yuan and an average annual growth rate of 16.66%;the total healthcare expenditure for CHCs increased to 87.752 billion yuan from 7.253 billion yuan,with an increase of 80.499 billion yuan,and an average annual growth rate of 31.92%;its occupation percentage in the total national healthcare expenditure increased to 2.38% from 0.79%,with an increase of 1.59 percentage points.From 2010 to 2015,the number of community health institutions increased from 32 739 to 34 321,with an increase of 1 582 and an average annual growth rate of 0.95%;in CHCs,the number of employees increased to 504 817 from 389 516,number of registered nurses increased to 153 393 from 106 528,number of practicing physicians increased to 181 670 from 144 225,and number of health professionals increased to 431 158 from 331 322,with a growth of 115 301,46 865,37 445,99 836,respectively,and an average annual growth rate of 5.32%,7.56%,4.72%,5.41%,respectively;the total revenue of CHCs increased to 13.371 million yuan from 8.054 million yuan,with an increase of 5.317 million yuan and an average annual growth rate of 10.67%;in CHCs,the number of emergency visits increased to 559.026 million from 347.404 million,with an increase of 211.622 million and an average annual growth rate of 9.98%,its occupation percentage in the total national emergency visits increased to 12.9% from 9.6%,with an increase of 3.3 percentage points;the number of inpatient visits in CHCs increased to 3.055 million from 2.181 million,with an increase of 0.874 million and an average annual growth rate of 6.97%,its occupation percentage in the total national inpatient visits increased to 7.6% from 5.5%,with an increase of 2.1 percentage points.Conclusion In recent years,the total national healthcare expenditure has increased significantly,and the occupation percentage of CHCs in the total national healthcare expenditure has increased with the rapid development of community health services.Promoting community health services delivery is an effective way for reasonably controlling healthcare expenditure growth.
作者
高颖
李丽清
GAO Ying,LI Li-qing(School of Economics and Management,Jiangxi Science & Technology Normal University,Nanchang 330013,Chin)
出处
《中国全科医学》
CAS
北大核心
2018年第13期1521-1526,共6页
Chinese General Practice
基金
国家自然科学基金资助项目(71473110)
江西省社会科学"十三五"(2017年)规划项目(17GL19)
关键词
社区卫生服务
卫生经费支出
费用控制
Community health services
Health expenditures
Cost control