筹资视角下的地级市卫生总费用结构变动趋势研究--以西部地级市A市为例

Study on The Change Trend of Total Health Expenditure Structure in Prefecture-level Cities from the Perspective of Financing-Taking the Western Prefecture-level City A as An Example

目的通过分析A市2011—2021年度卫生总费用的筹资水平与结构情况,探寻其结构变动规律,发现其筹资结构的不足,为其优化卫生总费用筹资结构提供科学的建议。方法本研究采用查询统计年鉴等方法,获取A市卫生总费用的相关数据,运用筹资来源法对相关数据进行核算,再结合结构变动分析法,深入剖析该市卫生总费用内部的变化规律。结果A市的卫生总费用从2011年的68.04亿元增加到2021年的161.05亿元,卫生总费用占GDP比重从2011年的4.31%上升到2021年的5.27%,人均卫生总费用从2011年1793.49元上升到2021年的3857.18元。政府、社会、个人卫生支出占比分别由2011年的27.13%、43.8%、29.07%变化为2021年的29.1%、43.62%、27.28%。2011—2021年间,该市的卫生总费用总体结构变动幅度为3.94%,其中政府卫生支出、社会卫生支出、个人卫生支出的结构变动值和结构变动贡献率两项指标,分别为1.97%(50.00%)、-0.18%(4.57%)和-1.79%(45.43%)。结论通过研究发现该市卫生总费用的筹资现状存在增长乏力、人均卫生总费用及其占GDP的比重需持续提高等问题。针对问题本文提出了拓宽社会卫生筹资渠道,构建卫生费用信息监管体系,强化政府卫生支出规模,提供多层次的医疗保障等对策建议。

Objective By analyzing the financing level and structure of total health expenditure in A city from 2011 to 2021,this paper explores the law of structural change,finds out the shortcomings of its financing structure,and provides scientific suggestions for optimizing the financing structure of total health expenditure.Methods In this study,the relevant data of total health expenditure in city A were obtained by means of query statistical yearbook,and the relevant data were calculated by means of financing source method.Combined with the structural change analysis method,the internal change law of total health expenditure in city A was deeply analyzed.Results The total health expenditure of city A increased from CNY 6.804 billion in 2011 to CNY 16.105 billion in 2021.The proportion of total health expenditure in GDP increased from 4.31%in 2011 to 5.27%in 2021,and the per capita total health expenditure increased from CNY 1793.49 in 2011 to CNY 3857.18 in 2021.The proportion of government,social and personal health expenditure changed from 27.13%,43.8%and 29.07%in 2011 to 29.1%,43.62%and 27.28%in 2021,respectively.From 2011 to 2021,the overall structural change of total health expenditure in the city was 3.94%.Among them,the structural change value and contribution rate of government health expenditure,social health expenditure and personal health expenditure were 1.97%(50.00%),-0.18%(4.57%)and-1.79%(45.43%),re spectively.Conclusion Through the study,it is found that there are some problems in the financing status of total health expenditure in the city,such as weak growth,per capita total health expenditure and its proportion in GDP need to be continuously improved.In view of the problems,this paper puts forward some countermeasures and suggestions,such as broadening the channels of social health financing,constructing the information supervision system of health expenditure,strengthening the scale of government health expenditure,and providing multi-level medical security.