卫生费用结构与户籍人口期望寿命的灰色关联度分析——以上海市为例

Grey relational analysis on health cost structure and life expectancy of registered population——An example from Shanghai

[目的]探析不同类型卫生费用支出对期望寿命的影响程度及其健康效用,为优化卫生服务资源配置提供参考。[方法]依据2001年以来上海市户籍人口期望寿命及卫生总费用数据,应用灰色关联度分析方法(GRA)探析卫生总费用结构和户籍人口期望寿命之间的关联性并加以排序,用以比较不同类型的卫生费用支出的健康效用。[结果]卫生费用支出对户籍人口期望寿命有显著的正向促进作用。在来源法核算体系中,各来源费用支出的健康效用依次为个人现金(0.9737)、政府(0.9623)、社会(0.9520);在机构法核算体系中,各机构费用支出的健康效用依次为公共卫生机构(0.9759)、基层医疗卫生机构(0.9758)、药品零售机构(0.9742)、其他(0.9641)、医院(0.9609)、卫生行政管理机构(0.7651)。[结论]当前卫生费用支出存在显著的结构性问题。优化卫生费用支出结构、提升卫生费用支出效率对于落实新医改成果意义重大。

Objective To explore the influence of different type health costs on life expectancy and its health utility so as to provide reference for optimizing health service resource allocation.Methods Based on the data of life expectancy of the registered population and health cost in Shanghai since 2001,the relationship between the structure of health cost and life expectancy of registered population was analyzed and ranked by grey relation analysis(GRA),to compare health utility of different types of health cost.Results Health cost had significant positive effect on the life expectancy of registered population.In the source-based accounting system,health utility of expenditure from various sources in proper order was personal cash(0.9737),government(0.9623),society(0.9520).In the law-based institutional accounting system,health utility of expenditure from various institutions in proper was public health institutions(0.9759),primary health care institutions(0.9758),drug retail institutions(0.9742),other institutions(0.9641),hospitals(0.9609),and health administration institutions(0.7651).Conclusions There are significant structural problems in health cost.Optimizing the structure of health cost and improving the efficiency of health cost are of great significance for the implementation of the results of the new medical reform.