2015年上海市卫生总费用核算结果及特点分析  

Analysis on the Results and Characteristics of Total Health Expenditure in Shanghai in 2015

作　　者：张晓溪[1,2] 王常颖[1,2] 李芬[1,2] 王力男[1,2] 金春林[1,2,3] 

机构地区：[1]上海市医学科学技术情报研究所,上海200031 [2]上海市卫生发展研究中心,上海200040 [3]上海市人口与发展研究中心,上海201199

出　　处：《中国卫生经济》2017年第8期24-28,共5页Chinese Health Economics

基　　金：美国中华医学基金会卫生体系研究与政策转化合作项目(CMB-CP 14-190);上海市第四轮公共卫生三年行动计划重点学科建设项目循证公共卫生与卫生经济学(15GWZK0901)

摘　　要：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 estimate the health accounts of Shanghai in 2015, summarize the characteristics of the collection, allocation and use of the health expenditure, and provide references for the health system development of Shanghai. Methods： Based on the framework of China National Health Accounts System（2003）, health accounts of Shanghai by financing source and health providers were calculated and analyzed. Results： In terms of the total volume of health financing, the total health expcnditurc（THE） （by source） in Shanghai in 2015 was 153.66 billion ynan, accounting for 6.1% of GDP, while the total health expenditnre per capita was 6 362.0 yuan. In terms of the financing structure, the health financing in Shanghai was mainly from social health expenditure（accounting for 57.4% of the THE）. Government health expenditure and out-of-pocket（OOP） expenditure accounted for 20.8% and 21.8% of THE in Shanghai respectively. In terms of the institutional allocation, THE（by organization） in Shanghai over the same period was 172.25 billion yuan, of which the medical institutions accounted for up to 85.2%. Conclusion： Overall, THE in Shanghai increased substantially in 2015. The prnportion of THE exceeded 6% for the first time. In the current economic situation, it was suggested to promote the integrated health system reform and control the rise of medical expenditure within a reasonable range, while encouraging the development of enmmercial insurance to ensure the sustainable development of the health financing of Shanghai.

关 键 词：地区卫生总费用 卫生费用核算 卫生筹资 上海 

分 类 号：R1[医药卫生—公共卫生与预防医学]