2017年中国卫生总费用核算结果与分析

Results and Analysis of National Health Accounts in China in 2017

目的:核算与分析2017年全国卫生总费用,并结合党的十八大以来中国卫生筹资变化情况,总结中国卫生筹资取得的阶段性成果和面临的主要问题,提出完善卫生筹资的政策建议。方法:采用来源法和机构法核算卫生费用,并采用时间序列的指标分析法研究中国卫生总费用变化情况。结果:2017年中国卫生总费用为52598.28亿元,增速降至10%以下,占GDP比重为6.36%。其中,政府卫生支出占比为28.91%,比2012年下降1.08个百分点;社会卫生支出占比为42.32%,比2012年上升6.65个百分点;个人卫生支出占比为28.77%,比2012年下降5.57个百分点。结论:党的十八大以来,个人卫生支出相对比重下降明显,药品费用占卫生总费用比重持续下降,但也面临一些需要关注的卫生筹资问题,需要继续强化政府卫生投入的约束和问责机制,完善多层次医疗保障体系,加大基层医疗卫生机构支持力度。

Objective:To estimate and analyze the total health expenditure(THE)in China in 2017,combining with the changes in China*s health financing since the 18th National Congress of the CPC,summarize the phased achievements and major problems in China's health financing,and put forward the policy suggestions for improving health financing.Methods:Health expenditure accounting methods by financing source and by health provider were applied.Index analysis method based on time series data was used to examine the changing trend of health expenditure in China.Results:China's THE was 5 259.828 billion yuan in 2017,which accounted 6.36%of GDP,and the THE growth rate slowed the increasing speed below 10%.The share of government health expenditure was 2&91%,which was 1.08%lower than that of 2012.The share of social health expenditure was 42.32%,which was 6.65%higher than that of 2012,while the out-of-pocket(OOP)was 28.77%,which was 5.57%lower than that of 2012.Conclusion:Since the 18th National Congress of the CPC,the OOP as share of THE by source had decreased significantly,and the pharmaceuticals expenditure as share of THE by provider had continued to decrease.However,there were still some health financing problems that needed to be paid attention to.It was necessary to continue to strengthen the restraint and accountability mechanism of government health investment,improve the multi-level medical security system,increase the support of grass-roots medical and healthcare institutions.