从筹资方案、收入和机构三个维度分析上海市卫生筹资状况

Analyzing Health Financing Status in Shanghai from Health Financing Schemes, Revenues and Institutions

目的:基于SHA 2011筹资维度框架核算上海市卫生费用,为政策制定者提供决策参考。方法:在SHA 2011分类原则下,从筹资方案、筹资方案收入和筹资机构三个维度进行核算。结果:2013年,上海市经常性卫生费用为1 083亿元,占GDP的比重是5.01%。经常性卫生费用中61.1%是公共筹资,但家庭现金卫生支出比例超过30%。卫生部门、人保部门分别管理14.3%和42.9%的资金。结论:上海市筹资体系由政府主导,部门间应建立联动机制以提高资金使用效率。OOP占比高,应靶向降低重点家庭现金卫生支出。鼓励非营利性机构和商业保险机构发展,建立多元化筹资体系。

Objective:Calculating health expenditure in Shanghai based on the financing dimension of System of Health Accounts2011(SHA 2011) so as to provide decision references for policy designers.Methods:Based on the classification principle of SHA2011,it performed to calculate from financing scheme,financing scheme revenue and financing institutions.Results:The current health expenditure in Shanghai was 108.3 billion yuan,accounting for 5.01%in GDP.The proportion of regular health financing schemes was 61.1%.The proportion of out Of pocket(OOP) was higher than 30%.Health sectors managed 14.3%of current health expenditure,42.9%of the fund was managed by labor and social security sector.Conclusion:The government played a leading position in Shanghai financing system.Linkage mechanism should be established among departments so as to promote fund usage efficiency.A target strategy should be build to decrease the OOP proportion.Non-profit organizations and commercial insurance institutions should be encouraged to create a diversified financing system.