新医改以来我国政府卫生投入评估分析——基于卫生筹资政策分析框架

Evaluation and Analysis of Chinese Government Health Investment Since the New Medical Reform——Based on the Policy Analysis Framework of Health Financing

目的:构建我国政府卫生投入分析框架和指标体系,评价新医改以来我国政府卫生投入情况,为完善政府卫生投入政策提供依据。方法:基于卫生筹资政策分析框架,确定政府卫生投入评价维度,结合政府卫生投入相关指标和政策目标,评估新医改以来我国政府卫生投入情况。结果:新医改以来,我国政府卫生投入规模持续扩大,但增速放缓;地方财政承担卫生支出的主要责任,可持续性存在挑战;地区差异不断扩大,“中部塌陷”现象需重视;基层医疗卫生机构和公共卫生机构投入力度有待加强。结论:应建立以健康结果为导向的投入机制,加大对公共卫生事业的投入力度,建立政府间的转移支付制度,探索提高对烟草等税收,并专门用于卫生健康领域。

Objective To construct the analysis framework and index system of government health investment in China,and to evaluate the situation of government health investment since the new medical reform,so as to provide a basis for perfecting government health investment policy.Methods Based on the policy analysis framework of health financing,this paper determines the evaluation dimension of government health investment,and combined with the relevant indicators and policy objectives of government health investment,evaluates the situation of government health investment in China since the new medical reform.Results Since the new medical reform,the scale of government health investment has continued to expand,but the growth rate has slowed down.Local finance bears the main responsibility for health expenditure,and sustainability is a challenge.With the continuous expansion of regional differences,attentions should be paid to the phenomenon of"central collapse".The investment of primary health care institutions and public health institutions needs to be strengthened.Conclusion It is necessary to establish a health outcome oriented investment mechanism,increase investment in public health,establish an inter-governmental transfer payment system,explore raising taxes on tobacco and used in the field of health.