摘要
目的:为我国卫生事业的发展中卫生总费用指标的评价提供参考。方法:选用国内外通用性更好的卫生总费用占GDP比重、广义政府卫生支出占GDP比重两个卫生费用指标,以及出生时的期望寿命、婴儿死亡率、新生儿死亡率、5岁以下儿童死亡率4个健康产出指标,分析不同GDP水平下,卫生费用指标处于何种水平时,会与"优"的健康产出有关。数据来源于世界银行和世界卫生组织官方网站,覆盖214个国家、1995—2012年的数据。结果:不同人均GDP水平下,卫生费用指标与人均GDP之间的散点分布有不同的规律,结合了健康产出也是如此。不同人均GDP水平下,卫生费用指标取值不一定越高,健康产出越好。建议:在GDP不断发展的过程中,动态的进行相关研究。影响卫生费用和健康产出的因素更多更复杂,可以根据数据的可得性纳入更多的影响因素进入研究。人均GDP区间划分可以更细,但不宜过细。不能一味要求卫生总费用各项指标持续增长,同时要考虑社会、居民的承受能力以及投入产出。一套标准不可能适用于所有国家和地区的卫生总费用投入的评价,要根据本国的实际特点做出分析。对于卫生工作的考核,要充分考虑到卫生事业发展的最终目的是要改善居民的健康水平而非增加投入。
Objective： To put forward some suggestions for the national health development in the filed of health expenditure indicators. Methods： Two health expenditure indicators and four health outcomes indicators were chosen from WB and WHO official websites,and researches on the relationship between health expenditure and outcomes were conducted. We put forward proposed value of the health cost indicator. Results： With different levels of GDP per capita,the scatter diagram of health expenditure and GDP per capita had different rules. When health outcomes were taken into consideration,the rules were the same. When GDP per capita was at different level,better health outcomes were not related to higher health expenditure. Input-output ratio should be taken into consideration fully.Suggestions： The study should be dynamic as GDP develops. More factors can be added in the research,if the data of the factors is available. In this study,the GDP per capita was divided into 4 sections. The division standard of the GDP per capita can be more delicate. What is more important for the development of health expenditure is not continuing input,but better input-output ratio because of diminishing of marginal returns. One set of standards cannot be adapted to all countries and districts. We should give full consideration to the improvement of people＇s health instead of increasing input because the ultimate goal is the former.
出处
《中国卫生政策研究》
CSCD
北大核心
2016年第7期66-73,共8页
Chinese Journal of Health Policy
基金
北京中医药大学基本科研业务费
北京市卫生计生委项目
关键词
卫生总费用
GDP
健康产出
Total health expenditure
GDP
Health outcome
