我国医学院校经费变化:基于东中西部地区的比较

Changes in funding for medical schools in China:A comparison based on the eastern,central and western regions of China

目的:分析1998—2017年我国东、中、西部地区医学院校经费水平、结构和差异的变化趋势以及影响因素,为医学教育宏观政策制定提供证据和建议。方法:先描述分析东、中、西部地区医学院校的校均经费水平与结构、生均经费水平和指数变化情况,再利用基尼系数和泰尔指数分析不同地区医学院校生均经费的差异程度和差异来源,最后建立分地区样本的生均经费的回归模型。结果:东中西部地区医学院校的经费收入均呈增长趋势,东部地区较高;财政拨款是第一大经费来源,其次为事业收入;生均经费的公平性较好,东、中部地区差异主要来源于区域各省内部;我国医学教育经费可能存在利用率较低的现象;人均GDP和第三产业占比对生均经费有显著的正向影响,在校生规模则相反。结论:我国东中西部地区医学教育经费变化各有特点,在政策制定时,应构建有针对性的管理思路。

Objective:To analyze the time changing trends of the funding level,structure,differences and influencing factors of medical schools in the eastern,central and western regions of China from 1998 to 2017,and provide evidence and suggestions for the formulation of macroeconomic policies for medical education.Methods:The level and structure of funding per institution,and the level and index of funding per student of medical schools in the eastern,central and western regions were firstly described,and then the Gini coefficient and Theil index were used to analyze the degree and source of differences in the average funding of healthcare institutions in the three regions.Finally,a regression model of the per-student funding of the regional samples was established.Results:The funding income of medical schools in the three regions showed increasing trends,and the eastern region was much higher than others.The financial appropriation was 40~70%of the average funding per school,was the largest source of funding,and the business income was the second largest source of funding.The equity of funding per student in the three regions was relatively good.Over the years,the differences that were observed between the eastern and central regions mainly came from within groups,while the differences between groups in western region showed a steady increase in recent years.The per student expenditure index indicated that China's health education funding may have a relatively low utilization rate.The regression results showed that per capita GDP and tertiary industry share ratio have a significant positive impact on the funding per student,while the size of school students is the opposite.Conclusions:Health education in different regions of China has its own characteristics;therefore,when making policies,the targeted management thinking should be tailor-suited and constructed.