有限医疗资源在全病种范围配置的有效性分析  

On the Efficiency of the Allocation of Limited Medical Resources across All Disease Categories

作　　者：俞乔[1] 杜修立[2] 赵昌文[3] 林一心 高先海 

机构地区：[1]清华大学公共管理学院 [2]南京财经大学金融学院 [3]四川大学商学院 [4]金华市人大常委会 [5]南充市人大常委会

出　　处：《中国社会科学》2013年第10期61-85,205-206,共25页Social Sciences in China

基　　金：国家自然科学基金(项目编号:70773066);清华大学公共管理学院产业发展与环境治理中心的支持

摘　　要：医疗保健制度的核心是如何对有限医疗资源进行有效配置。基于全病种范围资源配置分析框架,对我国东、西部两个典型城市住院病案超大样本数据集进行实证检验,结果显示:增加临床医疗开支可以显著改善几乎所有疾病类别的治疗结果;医疗开支对不同疾病类别的边际效应有显著差别;农村患者医疗投入的边际效应显著高于城市;基本医疗保险设计缺陷降低了医疗投入的效应。因此,应当较大幅度增加面向公众的基本医疗保健开支,增量资源需要进行跨病种有效配置,基本医疗保险对资源配置存在显著影响。The essence of the medicare system is to ensure an efficient allocation of limited medical resources.Based on the analytical framework of resource allocation across all disease categories,this study presents an empirical test of datasets gathered from an ultra-large sample of inpatient cases in two typical cities in eastern and western China.The results reveal that increasing clinical medical spending can remarkably improve the medical outcome of almost all disease categories,that medical spending has produced significantly different marginal effects on different disease categories,that medical spending has had a significantly higher marginal effect on rural patients than on urban ones,and that some deficiencies in the basic medical insurance system have offset the effects of medical investment.Therefore,China should increase considerably its basic medicare spending on the public,and should allocate incremental resources across disease categories in an efficient way.Basic medical insurance has remarkable effects on resource allocation.

关 键 词：全病种范围 资源配置效率 临床治疗结果 基本医疗保障 

分 类 号：R197.1[医药卫生—卫生事业管理]