上海市卫生总费用预测及影响因素分析——基于灰色模型

Prediction and Analysis of Influencing Factors of Total Health Expenditure in Shanghai—Based on Grey Model

目的:科学预测上海市卫生总费用的支出趋势及筹资结构,并从人口、经济、政策、卫生等角度分析影响上海市卫生总费用的因素,为上海市医疗卫生部门制定医疗卫生政策、发展医疗卫生事业控制医疗卫生费用提出合理意见。方法:数据来源于2010~2017年上海市统计年鉴,采用GM(1,1)灰色预测模型灰色关联模型对上海市卫生总费用进行预测和影响因素关联度分析。结果:2018~2027年十年内,上海市卫生总费用、政府卫生支出、社会卫生支出和个人卫生支出均出现不断上升的趋势;农村居民人均可支配收入、农村居民医疗卫生支出占人均消费支出的比重、城镇居民人均可支配收入的灰色关联度排在前三位,而常住人口数量和政府卫生支出占总支出的比重排在末两位。结论:上海市卫生筹资结构更加合理,人民健康水平不断提升,经济因素和卫生消费因素是影响上海市卫生总费用的主要因素,政策因素、人口因素中的常住人口数量对上海市卫生总费用影响最弱。

Objective: To scientifically predict the expenditure trend and financing structure of the total health expenses in Shanghai, analyze the factors affecting the total health expenses in Shanghai from the perspectives of population, economy, policy and health, and put forward reasonable suggestions for the medical and health departments in Shanghai to formulate the medical and health policies and develop the medical and health undertakings to control the medical and health expenses. Methods: The data were obtained from the statistical yearbook of Shanghai from 2010 to 2017. The GM(1,1) grey prediction model and grey correlation model were used to predict the total health expenditure in Shanghai and analyze the correlation degree of influencing factors. Results: In the decade from 2018~2027, the total health expenditure, government health expenditure, social health expenditure and personal health expenditure of Shanghai all showed a rising trend;per capital disposable income of rural residents, the proportion of rural residents’ medical and health expenditure in per capita consumption expenditure, and the grey correlation degree of per capita disposable income of urban residents rank the first three, while the number of permanent residents and the proportion of government health expenditure in the total expenditure rank the last two. Conclusion: The Shanghai health financing structure is more reasonable, improve people’s health level, economic factors and health consumption are the main factors influencing the total health expenses in Shanghai, policy factors, the number of the population of permanent residents in demographic factors influence on the total health expens-es in Shanghai the weakest.