新医改前后我国卫生总费用影响因素变化研究

Analysis on Influencing Factors of Total Health Expenditure before and after the New Medical Reform in China

目的:观察新医改前后我国卫生总费用影响因素的变化,筛选出我国目前卫生费用的主要影响因素,为缓控卫生费用的不断增长及政策与措施的完善提供借鉴和参考。方法:利用PLS偏最小方程法构建结构方程模型,并进行拟合度检验。结果:结构方程模型拟合度检验合理;新医改前影响卫生总费用的直接因素为需要因素,新医改后影响卫生总费用的直接因素变成非需要因素。结论:新医改后,我国卫生费用过快增长的问题仍然突出;卫生总费用防控的重点应针对非需要影响因素采取措施;新时期应聚焦提高卫生资源的利用效率和配置公平性,加快落实分级诊疗等各项举措,有效控制卫生总费用的不合理增长。

Objective:To observe the changes in the influencing factors of China’s total health costs before and after the new medical reform,and screen out the main influencing factors of China’s current health costs to provide references for slowing down the continuous growth of health costs and improving policies and measures.Methods:PLS partial least equation method was used to construct the structural equation model and test the fitting degree.Results:The fitting degree test of the structural equation model was reasonable.The direct factor that affected the total health cost before the new medical reform was the need factor,while the direct factor that affected the total health cost after the new medical reform was the non-need factor.Conclusion:After the new medical reform,the problem of excessively rapid increase in health expenses in China was still outstanding;the focus on the prevention and control of total health expenses should take measures against unneeded influencing factors;in the new period,it should focus on improving the utilization efficiency and equity of health resources and accelerating the implementation of hierarchical diagnosis,medical insurance supply-side reforms,social medical management and other measures to effectively control the unreasonable increase in total health expenses.