To get a clear sense of the“appropriate”individual payout,based on the literature reviews and the World Health Organization(WHO)reports,the study analyzes the data from two aspects:191 WHO member states and 76 super...To get a clear sense of the“appropriate”individual payout,based on the literature reviews and the World Health Organization(WHO)reports,the study analyzes the data from two aspects:191 WHO member states and 76 superior states(the health performance is better than that of China)by using the Panel data model,which was further validated by intention questionnaire.The results show that Chineseappropriate individual payout intervals are respectively around 30%from the WHO angle and the superior state angle in 2020,which have been well proved by the survey of intention.For the realization of the feasible structure of total expenditure on health,we need not only the efforts from government,society and individuals but also the cooperation among hospitals,drug supply security system,health care systems and other health systems.展开更多
目的:了解中国卫生筹资转型的主要特征及历史沿革。方法:数据来源于全球卫生支出数据库(Global Health Expenditure Database,GHED)、《中国卫生健康统计年鉴》、《全国卫生健康财务年报》、《中国卫生总费用研究报告》等。采用描述性...目的:了解中国卫生筹资转型的主要特征及历史沿革。方法:数据来源于全球卫生支出数据库(Global Health Expenditure Database,GHED)、《中国卫生健康统计年鉴》、《全国卫生健康财务年报》、《中国卫生总费用研究报告》等。采用描述性统计和文献研究法进行分析。结果:21世纪以来,全球多数国家出现了卫生筹资转型现象,表现为卫生筹资规模扩大和公共筹资责任强化。中国的卫生筹资转型特征十分鲜明:一是卫生筹资规模扩大的速度更快,2000—2019年人均卫生总费用按可比价格水平增长了816.6%,明显快于全球其他国家的平均增长速度(102.1%);二是公共筹资责任强化的力度更大,2000—2019年个人现金卫生支出占卫生总费用的比例下降了30.6个百分点,降幅明显大于全球其他国家的平均水平(5.6个百分点);三是公共筹资中政府卫生支出的流向发生了重要转变,“补需方”占比逐渐提高,并于2011年超过“补供方”,同时,在“补供方”内部“补医院”占比持续增加,明显高于“补基层”和“补公卫”。据此可将中国卫生筹资转型扩展为规模维度、结构维度和流向维度三个维度。运用分析框架,将中国卫生筹资转型大致分为计划经济时期、经济转型时期、“后非典”时期和“新医改”以来4个阶段,并对每个阶段的主要特点和演变逻辑进行了分析。结论:应从系统结构功能层面提高卫生筹资体系的纵向“嵌入性”和横向“互补性”;更加突出卫生筹资转型对维护隐性价值和防范公共风险的作用,完善价值与风险的双向权衡机制;统筹兼顾卫生筹资转型所涉及的卫生健康伦理原则,优化政府实际治理模式下的预算决策机制;高度重视现代医学发展的全局性和深层次影响,探索中国卫生筹资转型的长期战略和路径选择。展开更多
基金This work was supported by the National Natural Science Foundation of China under Grant numbers 71172131,71403185,71531010 and 71325003.
文摘To get a clear sense of the“appropriate”individual payout,based on the literature reviews and the World Health Organization(WHO)reports,the study analyzes the data from two aspects:191 WHO member states and 76 superior states(the health performance is better than that of China)by using the Panel data model,which was further validated by intention questionnaire.The results show that Chineseappropriate individual payout intervals are respectively around 30%from the WHO angle and the superior state angle in 2020,which have been well proved by the survey of intention.For the realization of the feasible structure of total expenditure on health,we need not only the efforts from government,society and individuals but also the cooperation among hospitals,drug supply security system,health care systems and other health systems.
文摘目的:了解中国卫生筹资转型的主要特征及历史沿革。方法:数据来源于全球卫生支出数据库(Global Health Expenditure Database,GHED)、《中国卫生健康统计年鉴》、《全国卫生健康财务年报》、《中国卫生总费用研究报告》等。采用描述性统计和文献研究法进行分析。结果:21世纪以来,全球多数国家出现了卫生筹资转型现象,表现为卫生筹资规模扩大和公共筹资责任强化。中国的卫生筹资转型特征十分鲜明:一是卫生筹资规模扩大的速度更快,2000—2019年人均卫生总费用按可比价格水平增长了816.6%,明显快于全球其他国家的平均增长速度(102.1%);二是公共筹资责任强化的力度更大,2000—2019年个人现金卫生支出占卫生总费用的比例下降了30.6个百分点,降幅明显大于全球其他国家的平均水平(5.6个百分点);三是公共筹资中政府卫生支出的流向发生了重要转变,“补需方”占比逐渐提高,并于2011年超过“补供方”,同时,在“补供方”内部“补医院”占比持续增加,明显高于“补基层”和“补公卫”。据此可将中国卫生筹资转型扩展为规模维度、结构维度和流向维度三个维度。运用分析框架,将中国卫生筹资转型大致分为计划经济时期、经济转型时期、“后非典”时期和“新医改”以来4个阶段,并对每个阶段的主要特点和演变逻辑进行了分析。结论:应从系统结构功能层面提高卫生筹资体系的纵向“嵌入性”和横向“互补性”;更加突出卫生筹资转型对维护隐性价值和防范公共风险的作用,完善价值与风险的双向权衡机制;统筹兼顾卫生筹资转型所涉及的卫生健康伦理原则,优化政府实际治理模式下的预算决策机制;高度重视现代医学发展的全局性和深层次影响,探索中国卫生筹资转型的长期战略和路径选择。
