《健康上海行动》计划背景下卫生费用的中长期预测——非传染性慢性疾病防治计划的影响

Medium-and long-term projection for health expenditure with the implementation of Healthy Shanghai Initiative:The influence of chronic disease prevention and control plan

目的:卫生费用过快上涨一直是政策关注的重点,本研究旨在对上海市卫生费用开展中长期预测并对《健康上海行动》计划中有关慢性疾病防治计划对卫生费用的影响开展政策模拟。方法:基于上海市卫生费用核算数据,利用组分模型对2020—2035年卫生总费用开展预测和政策模拟分析。结果:2020—2035年,预测上海市卫生费用将持续增长,预计2023年卫生总费用占GDP的比例超过8.00%,2025年达到9.00%,2035年达到10.03%。经常性卫生费用占GDP的比例2024年超过8.00%,2029年超过9.00%,2035年达到9.55%。慢性疾病防治计划有助于降低呼吸系统疾病、内分泌系统疾病和循环系统疾病的医疗费用,预计能节省卫生总费用的3.28%~10.58%。结论:上海市卫生筹资的可持续性在经济新常态下面临挑战,应从供需双方共同推进非传染性慢性疾病的防治,加强费用控制。

Objective:The rapid growth of health expenditure has always been the focus of health policy.This study aims to project health expenditure in Shanghai and to carry out policy simulations on the impact of chronic disease prevention programs on health costs in the Healthy Shanghai Initiative.Methods:Based on the Shanghai health accounts,component-based model was used to project Shanghai total health expenditure of 2020-2035,and the policy stimulation was implemented.Results:In 2020-2035,Shanghai’s health expenditure is expected to grow continually,the proportion of total health expenditure in GDP will exceed 8.00%in 2023,reach 9.00%in 2025,and 10.03%in 2035.The proportion of current health expenditure in GDP will exceed 8.00%in 2024 and reach 9.55%in 2035.The chronic disease prevention plan help saving the medical expenditure of respiratory diseases,endocrine system diseases,and circulatory system diseases,accounting 3.28%to 10.58%of total health expenditure.Conclusion:The sustainability of health financing in Shanghai is facing challenges under the new normal of economy.It is necessary to promote the prevention and control of chronic diseases and strengthen cost control from both the supply and demand sides.