2018年中国卫生总费用核算结果与分析

The Results and Analysis of National Health Accounts in China in 2018

目的:对2018年全国卫生总费用进行核算与分析,并分析2012年以来我国卫生筹资变化情况,分析近年来我国卫生筹资存在的主要问题,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:2018年中国卫生总费用为59 121.91亿元,增速降至9.20%,占GDP比重为6.57%。其中,政府卫生支出占比为27.74%,比2012年下降2.25个百分点;社会卫生支出占比为43.66%,比2012年上升了近8个百分点;个人卫生支出占比为28.61%,比2012年下降5.73个百分点。结论:2012年以来,我国卫生筹资结构逐步优化,社会卫生支出水平不断提高,个人卫生支出相对比重下降明显,但仍需要建立完善稳定长效的公共筹资机制,发挥医疗保险战略购买作用,控制不合理卫生费用增长。

Objective:To estimate and analyze total health expenditure in China in 2018,analyze the changes in health financ⁃ing from 2012 to 2018,summarize the major issues faced by health financing system in China,and propose policy suggestions for im⁃proving health financing policy.Methods:Health expenditure accounting method by financing source and by health provider are ap⁃plied,and time series data is analyzed to examine the changing trend of health expenditure in China.Results:Total health expendi⁃ture in China is 5912.19 billion yuan in 2018,which accounts for 6.57%of GDP,and its growth rate is 9.20%.The share of govern⁃ment health expenditure is 27.74%,2.25 percentage points lower than 2012.The share of social health expenditure is 43.66%,al⁃most 8 percentage points higher than 2012,while the out-of-pocket(OOP)is 28.61%,5.73 percentage points lower than 2012.Con⁃clusion:The structure of health financing has been optimized,OOP as a share of total health expenditure has declined significantly,and social health financing level has continued to increase.However,it is necessary to continue to strengthen the stable and sustain⁃able public financing mechanism,improve the strategic purchasing capacity of health insurance,and contain unreasonable health ex⁃penditure growth.