卫生筹资中社会卫生支出的预测与分析

Prediction and analysis of social health expenditure in health financing

目的:本文利用时间序列数据,在ARIMA-FDLMR两阶段分析框架下研究了社会、政府及个人与卫生筹资格局的关系。方法:首先,基于自回归积分滑动平均模型(ARIMA),借助2017年《中国统计年鉴》的数据,预测分析社会、政府、个人的实际卫生支出及其各自占GDP的比重;其次,通过2005—2015年社会卫生支出相关数据,建立时间序列有限分布滞后多元回归模型(FDLMR),分析了医疗卫生体制改革对社会卫生支出产生的影响。结果:ARIMA模型结果显示,社会卫生支出增长速度最快,所占GDP比重最大;政府持续加大医疗投入,但个人卫生支出在短时间内难以降低。FDLMR模型结果显示,社会保险基金支出、非公立医院数量以及社会捐赠对社会卫生支出具有显著影响。结论:鼓励社会资本参与医疗卫生改革是弥补卫生支出不足的有效途径,社会卫生支出将在卫生筹资发展与改革中起到重要补充作用,并且在未来非公立医疗机构将进一步凸显其价值。

Objective： This paper used time series data to study the relationship between society, government, individual and heahh financing pattern under the ARIMA-FDLMR two-stage analysis framework. Methods： Filet of all, based on the ARIMA model and using the data from the China Statistical Yearbook 2017, the actual health expenditures social, government, individual and their respective share of GDP were predicted and analyzed. Secondly, through the data on social health expenditures harvested during the period from 2005 to 2015, a Time Series Finite Distribution Lagged Multiple Regression Model （FDLMR） was established to statistically analyze the impact of the health care system reform on social health expenditure. Results： The results of ARIMA model displayed that social health expenditure bad the fastest growth rate and the largest share of GDP. The government continues to increase medical investment, but individual health expenditure is very difficult to be reduced in a short time. The results of the FDLMR model showed that social medical insurance expenditure, the number of non-public hospitals and social donations have a significant impact on social health expenditure. Conclusions： Encouraging social capital to participate in health care reform constitutes an effective way to cover the gap for lack of health expenditure. Social health expenditure will play an important complementary role in financing for social health development and reform, and non-public medical institutions will further highlight its value in the future.