基于灰色关联模型的上海市卫生总费用影响因素分析

Influencing factors for Shanghai's total healthcare expenditure based on the grey relational model

目的利用灰色关联模型对上海市卫生总费用的影响因素进行分析,以期为相关部门制定医疗卫生政策提供参考。方法采用2007—2016年《上海统计年鉴》,通过文献梳理、专家访谈,筛选出人均GDP、老龄化程度、医疗机构年诊疗人次等10项指标,采用灰色关联模型对上海市卫生总费用影响因素进行分析。结果所选所有指标灰色关联度均大于0.6,说明选取的参考数列具有一定的科学性;个人卫生支出、医院入院人数、人均医疗费用3项指标是上海市卫生总费用的主要影响因素;而人均GDP、肿瘤专率、老龄化程度等其他因素关联度则较低。结论上海市相关部门应该针对主要影响因素制定相应措施以控制卫生总费用的合理增长,优化卫生总费用筹资结构,提高全民健康水平和当地医疗卫生水平;构建以预防为主导的疾病防控体系,提高全民健康意识,加强健康教育,切实解决本地居民“看病难、看病贵”的问题。

Objective To analyze the influencing factors for Shanghai's total healthcare expenditure using the grey relational model in order to provide reference for formulating medical and health policies.Methods Using the"Shanghai Statistical Yearbook"of 2007~2016,and through literature review and expert interviews,we selected 10 indicators including per capita GDP,aging level and annual visits to medical institutions.The gray correlation model was used to analyze influencing factors for the total healthcare expenditure in Shanghai.Results The gray correlation level of all selected indicators was greater than 0.6,indicating that these indicators were scientifically valid;personal healthcare expenditure,hospital admissions and per capita medical expenditure were the main influencing factors;and other factors such as per capita GDP,tumor mortality,and aging level were not so closely related to Shanghai’s total healthcare expenditure.Conclusion Corresponding measures should be developed to control the growth of total healthcare expenditures to a rational level in Shanghai via optimizing the funding structure,and improving people’s health condition and the local medical and health capacity.A prevention-oriented disease control system should be established,enhancing health awareness of the population,strengthening health education and effectively solving the problem of"difficult access to see a doctor and expensive medical cost".