结构变动视角下新医改十年湖南省卫生总费用筹资及流向变化分析

Analysis on the financing and flow direction of total health expenditure in Hunan Province in the ten years of new medical reform from the perspective of structural change

[目的]通过对新医改10年来湖南省卫生总费用筹资及流向变化分析研究,为湖南省合理配置卫生资源,深化医疗体制改革,制定医改政策提供参考。[方法]采用结构变动值、结构变动度以及结构贡献率3个指标分析新医改前后湖南省卫生总费用筹资及流向变化情况。[结果]新医改10年来,湖南省卫生总费用逐年上升。筹资结构中社会卫生支出的结构变动值为正数,且结构变动贡献度最大,分别为15.28和50%。个人现金卫生支出和政府卫生支出占比分别下降12.08%和3.21%。卫生费用主要流向城市医院和县医院,占比大于50%。[结论]新医改10年来,湖南省个人现金卫生支出占比下降,但政府相关投入不足。基层医疗机构和公共卫生机构卫生资源配置仍不合理。

Objective To analyze and study the financing and flow direction of total health expenditure in Hunan Province in the ten years of new medical reform so as to provide reference for rational allocation of health resources, deepening medical system and formulating medical reform policy. Methods It analyzed the changes of financing and the flow of total health expenses before and after the new medical reform by the value of structural change, degree of structural change, structure contribution rate. Results In the past ten years of new medical reform, total health cost in Hunan Province had increased year by year. The structural change value of social health expenditure in financing structure was positive number and its contribution of structural change was the largest which was 15.28 and 50%,respectively. The proportion of personal and government health expenditure decreased by 12.08% and 3.21%,respectively. Health costs mainly flew to urban and county hospitals which accounted for more than 50%. Conclusions In the past ten years of the new medical reform, the proportion of personal cash health expenditure in Hunan Province has decreased, but the relevant government investment is insufficient. The allocation of health resources in primary medical institutions and public health institutions is still unreasonable.