2007-2021年湖北省卫生总费用及其影响因素分析

Analysis of Total Health Expenditure and Its Influencing Factors in Hubei Province from 2007 to 2021

目的:核算2007-2021年湖北省卫生总费用并分析其影响因素,为推动“十四五”时期湖北省卫生健康事业高质量发展提供有益的建议。方法:以筹资来源法卫生总费用核算为基础,分析湖北省2007-2021年卫生总费用筹资水平及构成,并构建分位数回归模型探究不同分位点下人均卫生总费用的影响因素。结果:湖北省卫生总费用不断增长,2021年达到3051.01亿元,卫生总费用占地区生产总值(GDP)比重(6.09%)略低于全国平均水平(6.72%)。2007-2021年湖北省卫生筹资逐渐以社会筹资为主,个人卫生支出占比不断降低。分位数回归结果显示,3个宏观因素对人均卫生总费用均有正向影响,分别为65岁及以上人口比例、人均地区生产总值(GDP)、政府卫生支出占财政比例。结论:湖北省卫生总费用筹资结构逐渐优化,个人卫生支出占比降低,但居民就医经济负担仍然较重。应适度增加政府卫生投入,着重优化投入方向,加大对公共卫生服务的资金投入,加强对老龄人口健康管理、护理服务的资金倾斜;科学整合医保制度,提高保险基金的使用效率,积极引导卫生总费用合理增长。

Objective:To account total health expenditure(THE)in Hubei province from 2007 to 2021 and analyze its influencing factors;so as to provide suggestions for promoting the high-quality development of health care career during the 14th Five-Year Plan period.Methods:Based on Health expenditure estimation methods by resource,this study analyzed financing level and composition of THE in Hubei province from 2007 to 2021,and explored the influencing factors of THE per capita at different quantile points constructed by quantile regression model.Results:The THE in Hubei province had been growing,reaching 305.101 billion yuan in 2021,the proportion of THE in GDP(6.09%)was lower than the national average(6.72%).Health financing in Hubei province had gradually become dominated by social health expenditure,and the share of out-of-pocket payment(OOP)had been decreasing.The results of quantile regression showed that three macro factors had a positive impact on the THE per capita,namely the proportion of the population over 65 years old,the per capita GDP and the proportion of government health expenditure to finance.Conclusion:The funding structure of healthcare expenditure in Hubei province is gradually optimizing,with a decrease in the proportion of OOP.However,the economic burden of medical expenses on residents remains relatively high.There should be a moderate increase in government healthcare investment,emphasizing the optimization of the investment direction.This includes increasing funding for public health services and reinforcing funding for healthcare management and nursing services for the elderly.And scientific integration of the medical insurance system is necessary to enhance the efficiency of insurance funds usage and actively guide a reasonable growth in total healthcare expenditure.