我国卫生总费用及其筹资结构的预测研究--基于灰色系统GM(1,1)模型

Study on the prediction of total health expenditure and its financing structure in China--Based on GM(1,1)model of Grey System

[目的]分析我国卫生总费用及其筹资结构的现状,并对“十四五”期间我国卫生总费用及其构成进行科学预测,为相关部门科学控制筹资水平、合理调整筹资结构、及时监控及预警提供科学建议。[方法]运用卫生总费用筹资分析,从筹资水平及筹资结构分析当前我国卫生总费用的发展现状,并使用GM(1,1)预测模型对2019-2025年我国卫生总费用及其筹资结构进行预测。[结果](1)2005-2018年,我国卫生总费用、人均卫生总费用、卫生总费用占GDP比重均有明显上升,卫生消费弹性系数常年大于1。且政府和社会卫生支出占比逐年上升、个人卫生支出占比逐年下降。(2)由预测结果可知,卫生总费用与GDP逐年增长,2025年卫生总费用占GDP的比重上升至7.91%,政府及社会个人卫生支出比重逐年上升至28.34%、52.59%,个人卫生支出逐年下降至22.62%。[结论]当前及未来,我国卫生总费用逐年增长、卫生资源配置公平性得到改善、资金投入不断增大。但仍存在增速过快、影响因素较多、个人卫生支出比重较高等问题,需不断深化以政府为主导的卫生支出投入,降低个人卫生支出比重,提高预防服务水平。

Objective In order to provide scientific suggestions for relevant departments controlling financing level,adjusting the financing structure,monitoring in time and early warning,this paper analyze current situation and financing structure of China's total health expenditure,forecast the trend of China's total health expenditure and its composition during“14th Five-Year Plan”.Methods It analyzed current development of China's total health expenditure from the perspective of financing level and structure;Predicted the total health expenditure and its financing structure from 2019 to 2025 by GM(1,1)forecasting model.Results 1.From 2005 to 2018,China's total health expenditure,total health expenditure per capita and the proportion of total health expenditure in GDP increased significantly,and the elasticity coefficient of health consumption was bigger than 1 all year round.The proportion of government and social health expenditure had increased and personal health expenditure had decreased year by year.2.According to the prediction results,the total health expenditure and GDP increased year by year.In 2025,the proportion of total health expenditure in GDP will increase to 7.91%,the proportion of government and social personal health expenditure will increase to 28.34%and 52.59%,and the proportion of personal health expenditure will decrease to 22.62%.Conclusions At present and in the future,China's total health expenditure is increasing year by year,the fairness of health resource allocation is improved,and the capital investment is increasing.However,there are still problems such as too fast growth,many influencing factors and high proportion of personal health expenditure.It is necessary to continuously deepen the government-oriented health expenditure investment,reduce the proportion of personal health expenditure and improve the level of prevention services.