新医改以来广西与全国居民医疗保健费用的比较

Comparison of medical and healthcare expenses between Guangxi and national residents since new round of medical reform

目的了解2009~2017年广西居民医疗保健经济负担情况,评价新医改以来广西取得的成就并提出相关政策建议。方法收集《中国卫生健康统计年鉴》和《中国卫生总费用研究报告》中,2009~2017年广西和全国居民医疗保健费用的相关数据。分析2009~2017年广西与全国卫生总费用及其占GDP的比重情况、人均卫生总费用及其增速变化情况、卫生总费用构成及其变化情况、城乡居民人均医疗保健支出及变化情况,评价新医改以来广西取得的成就并提出针对性的政策建议。结果2009~2017年,广西卫生总费用由407.06亿元增至1392.98亿元,总体呈上升趋势,卫生总费用增长速度放缓;卫生总费用占GDP的比重由5.25%增至6.83%,总体呈增长趋势;人均卫生总费用从2009年的838.27元持续增至2017年的2851.55元,但持续低于全国平均水平。2017年,广西卫生总费用的政府卫生支出、社会卫生支出和个人现金卫生支出占比分别为37.27%、35.60%、27.13%;城镇居民人均医疗保健支出为1254.00元,占人均消费性支出比重为6.80%,农村居民人均医疗保健支出为931.00元,占人均生活消费支出比重为9.90%。结论新医改以来,广西卫生总费用增速放缓,占GDP比重高于全国水平,但人均卫生总费用偏低;个人现金卫生支出比重降至30%以下,政府卫生支出比重和社会卫生支出比重有所增加,但社会卫生支出增量不足;城镇居民人均医疗保健支出呈现“两低一高”,农村居民医疗保健支出“两高一低”。政府应该持续加大卫生健康领域的投入,增加医疗保健支出,缩小城乡差距,提高人民群众的健康水平。

Objective To understand the status of medical and healthcare economic burden of Guangxi residents during 2009 and 2017,and to evaluate the achievements made in Guangxi since new round of medical reform and put forward suggestions on relevant policies.Methods The relevant data of Guangxi and national residents′medical and healthcare expenses during 2009 and 2017 were collected from Health Statistics Yearbook of China and Research Report of Total Health Expenditure in China.An analysis was performed on Guangxi and national total health expenditure and their GDP share,total health expenditure per capita and its growth variance,constitution of total health expenditure and its variance,and per capita medical and healthcare expense of urban and rural residents and its variance between 2009 and 2017 to assess the achievements made in Guangxi since new round of medical reform and put forward specific policy suggestions.Results During 2009 and 2017,the total health expenditure in Guangxi rose from 40.706 billion yuan to 139.298 billion yuan,overall presenting an upward trend,and the total health expenditure grew slowly;the total health expenditure to GDP ratio rose from 5.25%to 6.83%,overall presenting an upward trend;the total health expenditure per capita kept rising from 838.27 yuan in 2009 to 2851.55 yuan in 2017,but constantly lower than the national average level.In 2017,government health expenditure,social health expenditure,and personal cash health expenditure accounted for 37.27%,35.60%and 27.13%,respectively,of the total health expenditure in Guangxi;per capita medical and healthcare expenditure of urban residents rea ched 1254.00 yuan,accounting for 6.80%of per capita consumption expenditure,and per capita medical and healthcare expenditure of rural residents reached 931.00 yuan,accounting for 9.90%of per capita living expenditure.Conclusion Since new round of medical reform,the total health expenditure in Guangxi has grown more slowly,and its GDP share is higher than the national level,but the total health expenditure per capita is slightly low;the proportion of personal cash health expenditure drops to below 30%,the proportions of government health expenditure and social health expenditure are on the rise,but the increment of social health expenditure is insufficient;urban residents have low level of per capita medical and healthcare expenditure,low ratio of per capita medical and healthcare expenditure to living expenditure,and increased growth of per capita medical and healthcare expenditure;rural residents have increased growth of per capita medical and healthcare expenditure,high ratio of per capita medical and healthcare expenditure to living expenditure,and low level of per capita medical and healthcare expenditure.The government should invest more funds in health care,increase medical and healthcare expenditure,diminish the gap between urban and rural areas,and improve people′s health.