中国基本公共卫生服务财政投入现状与可持续性研究

Research on the status quo and sustainability of financial investment in basic public health services project in China

作为我国深化医药卫生体制改革的重要内容与“健康中国”战略实施的重要环节,基本公共卫生服务由国家财政保障实施。为评估我国基本公共卫生服务财政投入现状与可持续性,本文使用2010—2019年的国家财政决算数据,对基本公共卫生服务财政投入分别进行静态与动态变化分析,并对未来十五年国家基本公共卫生服务投入规模进行预测。结果显示,基本公共卫生服务项目财政投入增长较快,其对财政收入的依存度、弹性均较高,并且在未来十五年内仍将保持较高水平,导致目前基本公共卫生服务财政投入机制的可持续性较弱。因此,为增强基本公共卫生服务财政投入机制的稳定性与可持续性,本文提出四点完善财政投入机制的政策建议。

As an important part of deepening the reform of medicine and the health care system and promoting the“Healthy China”strategy,the implementation of the National Basic Public Health Service(BPHS)project is guaranteed by fiscal funds.To assess the status quo and sustainability of financial investment in the BPHS project,data collected from 2010—2019 National Government Final Accounts are used to analyze the static and dynamic trends of financial investment in the BPHS project.Future financial investment in BPHS in the upcoming 15 years is predicted as well.The results show that the BPHS project expenditure increases rapidly.Both the dependence on public finance of BPHS expenditure and its fiscal elasticity are high.Meanwhile,the dependence and fiscal elasticity will maintain a high level in the next 15 years,resulting in a weak sustainability of the current BPHS financial investment mechanism.Therefore,to raise the stability and sustainability of the financial input mechanism of basic public health services,this study puts forward four policy suggestions to improve the financial input mechanism.