“十三五”以来全国及各地区个人卫生支出分析

Analysis on Household Out-of-pocket Payments at National and Provincial Level since“the 13th Five-Year Plan”

目的:对"十三五"以来全国及各地区个人卫生支出及其占卫生总费用比重变化进行分析,分析变化原因并提出进一步降低居民个人负担的建议。方法:利用来源法核算我国卫生总费用,利用时间序列指标分析法研究全国及各地区个人卫生支出变化情况。结果:"十三五"以来,按可比价格计算,我国居民人均个人卫生支出增长速度趋缓,由2016年的9.39%降至2018年的8.15%,但显著高于"十二五"时期平均水平。个人卫生支出占比下降趋缓,2016-2018年仅下降0.17个百分点。部分地区人均个人卫生支出增速提高,个人卫生支出占比出现反弹。结论:若2020年部分地区个人卫生支出占比不出现较大下降,全国层面将个人卫生支出占比降到28%有一定压力。需要进一步完善卫生筹资政策,在确保政府和基本医疗保险等公共投入力度的同时,不断扩充其他社会筹资渠道。

Objective:To analyze household out-of-pocket(OOP)and its proportion of total health expenditure at national and pro⁃vincial level since the 13th Five Year Plan(2016 to 2018),analyze the main reasons of the trends,and propose suggestions for further reducing residents’health financial burden.Methods:Health expenditure accounting method by financing source and time series da⁃ta on OOPs at national and provincial level are applied in the study.Results:Since“the 13th Five Year Plan”,the growth rate of real per capita OOPs has slowed down from 9.39%in 2016 to 8.15%in 2018,which is much higher than the average level of“the 12th Five Year Plan”.The decline in the proportion of OOPs in total health expenditure has slowed down and went down by 0.17 per⁃centage points from 2016 to 2018.At provincial level,the growth rate of per capita OOPs and the proportion of OOPs in total health expenditure rebounds in several provinces.Conclusion:There will be some pressure to reduce the proportion of OOPs to 28%at the national level if the OOPs’share in total health expenditure in some provinces does not decline significantly by 2020.Therefore,it is necessary to further improve the health financing policy,while ensuring public finance such as government and basic health insurance schemes,continuously expanding other social financing channels.