新医改能遏制医疗支出上涨吗  

Can New Medical Reform Curb Rise of Medical Expenditure

作　　者：高春亮[1] 余晖[2] Gao Chunliang;Yu Hui

机构地区：[1]南京财经大学南京都市圈发展研究中心 [2]中国社会科学院工业经济研究所

出　　处：《江海学刊》2019年第3期73-79,254,共8页Jianghai Academic Journal

基　　金：国家自然科学基金项目"人力资本视角下的城市增长与创新集中研究:微观机制和宏观政策"(项目号:71774076)的阶段性成果

摘　　要：医疗总支出和个人自付数量增长降低了居民获得感,削弱了新医改成效。基于健康资本模型讨论医疗支出微观决定机制的结论表明,技术进步与医疗资源投入密不可分且正相关,共同促进医疗支出增长。基于2005～2016年31个样本省份数据的实证检验表明,内生性导致高估供给诱导需求的贡献,基于结构方程模型的估计结果进一步表明技术进步为医疗支出上涨的主因。由于供给诱导需求和技术进步边界难以厘定,易将技术进步贡献计入供给诱导需求,这种误判不利于达成新医改降低医疗支出的目标。在深化医改进程中,应建立医疗价格增长的识别机制,对于先进医疗技术的推广应审慎而行。The growth of total medical expenditure and personal payment has reduced the residents’ sense of benefit and weakened the effectiveness of the new health care reform. Based on Ramsey’s function, a health capital model is established to discuss the micro-mechanism of medical expenditure decision. The conclusion shows that technological progress is inseparable and positively related to medical resources investment, and jointly promotes the growth of medical expenditure. Empirical tests in 31 provinces from 2005 to 2016 show that endogeneity leads to overestimation of supply-induced demand(SID) contribution, while structural equation shows that technological progress is the main cause of rising medical expenditure.

关 键 词：医疗支出 健康资本 供给诱导需求 技术进步 

分 类 号：R197.1[医药卫生—卫生事业管理]