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目的:分析2015年上海市卫生总费用核算结果,对上海市卫生总费用筹集、分配和使用特点进行归纳,为上海市医疗卫生服务体系建设提供决策参考和依据。方法:依照《国家卫生总费用核算体系》(2003年)核算框架,采用来源法和机构法对上海市卫生总费用进行核算和分析。结果:从筹资总量来说,2015年上海市卫生费用(来源法)总额为1536.60亿元,占GDP的比重为6.12%,人均卫生总费用为6 362.02元。从筹资结构来说,上海市卫生总费用来源以社会卫生支出为主(占总费用57.43%),政府卫生支出和个人卫生支出占比分别为20.82%和21.75%。从机构分配来说,同期上海市卫生费用(机构法)总额为1 722.51亿元,其中医疗机构费用占比高达85.23%。结论:总体来说,2015年上海市卫生总费用增长较快,卫生总费用占比首次突破6%,建议在当前经济形势下一体化推进医药卫生机制改革,将医疗费用上升控制在合理范围内,同时鼓励商业保险,确保资金可持续发展。
OBJECTIVE: To analyze the accounting results of total health expenditure in Shanghai in 2015, summarize the features of raising, allocating and using the total health expenditure in Shanghai, and provide reference and basis for the decision-making of Shanghai’s medical and health service system. Methods: According to the accounting framework of National Total Health Accounts (2003), the total health expenditure of Shanghai was calculated and analyzed by using the source and agency laws. Results: From the total amount of financing, the total amount of health expenditure (Source of Law) in Shanghai in 2015 was 153.66 billion yuan, accounting for 6.12% of GDP, and the per capita health expenditure was 6,362.02 yuan. From the funding structure, the total source of expenditure for health in Shanghai is mainly social health expenditure (accounting for 57.43% of the total), with government expenditure on health and personal health accounting for 20.82% and 21.75% respectively. In terms of institutional distribution, the total expenditure on sanitation (agency law) in Shanghai in the same period was 172.251 billion yuan, of which 85.23% was the cost of medical institutions. Conclusion: Overall, the total health expenditure in Shanghai increased rapidly in 2015, accounting for 6% of the total health expenditure for the first time in 2015. It is suggested that the reform of medical and health mechanisms should be integrated under the current economic situation and the increase of medical expenses should be controlled within a reasonable range , While encouraging commercial insurance to ensure the sustainable development of funds.