新医改后我国卫生费用筹资现状及趋势预测分析

Analysis on the Current Situation and Trend of Health Expenditure Financing in China after the New Medical Reform

目的对新医改10年后我国卫生费用现状进行评价,并对“十四五”期间卫生费用情况进行预测,为我国卫生费用政策调整提供依据。方法对2010-2019年卫生费用筹资总额、构成、变化趋势等进行现状描述,运用ARIMA模型对“十四五”期间卫生费用筹资水平与结构进行预测。结果新医改后我国卫生总费用年均增长率为14.17%,其占GDP的比重10年间增加了1.8%。从卫生筹资结构来看,政府占比下降了1.33%,社会占比增加了8.25%,个人占比下降了6.93%。“十四五”期间的预测显示,筹资水平将持续上升,政府、社会、个人的卫生支出比例将达到为3∶5.3∶1.7。结论新医改后我国卫生筹资水平逐年提升、结构逐步优化、个人负担水平大幅度降低,社会支出在卫生筹资中占有重要地位,同时也存在卫生费用增长过快,卫生筹资困难等问题。对此还需控制卫生费用的合理增长,进一步优化筹资结构,保证个人自付比例始终保持较低水平,丰富社会筹资渠道。

Objective To evaluate the current situation of health expenditure in China 10 years after the new health care reform,and forecast the health expenditure situation during the“14 th five-year plan”period,so as to provide the basis for the policy adjustment of health expenditure in China.Methods The total amount,composition and change trend of health expenditure financing from 2010 to 2019 were described.ARIMA model was used to predict the level and structure of health expenditure financing during the“14 th five-year plan”.Results After the new health care reform,the average annual growth rate of total health expenditure was 14.17%,and its proportion in GDP increased by 1.8%in 10 years.From the perspective of health financing structure,the proportion of government decreased by 1.33%,the proportion of society increased by 8.25%,and the proportion of individuals decreased by 6.93%.The forecast during the 14 th Five-Year Plan period shows that the financing level will continue to rise,and the proportion of government,society and individual health expenditure will reach 3∶5.3∶1.7.Conclusion After the new health care reform,the level of health financing has been improved year by year,the structure has been gradually optimized,and the level of individual burden has been greatly reduced.Social expenditure plays an important role in health financing.At the same time,there are also problems such as the rapid growth of health expenditure and the difficulty of health financing.In this regard,it is necessary to control the reasonable growth of health expenditure,further optimize the financing structure,ensure that the proportion of individual out of pocket always remains at a low level,and enrich social financing channels.