健康中国背景下的“看病贵”与政府支出——基于资源配置结构性失衡视角的分析  

“Kan Bing Gui”and Fiscal Expenditure on the Healthy China Initiative:Based on Structural Imbalances in the Allocation of Medical and Health Resources

作　　者：庞瑞芝[1] 李倩楠 PANG Ruizhi;LI Qiannan(Center for Enterprise Research,Nankai University,Tianjin 300071,China;School of Economics,Nankai University,Tianjin 300071,China)

机构地区：[1]南开大学企业研究中心,天津300071 [2]南开大学经济学院,天津300071

出　　处：《西安交通大学学报（社会科学版）》2024年第2期104-116,共13页Journal of Xi'an Jiaotong University：Social Sciences

基　　金：国家社会科学基金重点项目(21AJY012);教育部人文社会科学基金项目(20YJA790057)。

摘　　要：“看病贵”意味着医疗卫生资源转化为医疗卫生服务的成本高,有限资源下医疗卫生服务供给的数量和质量难以满足公众健康需求,从而直接影响健康中国建设。同时,人口快速老龄化带来的医疗卫生需求爆发式增长,将形成医疗卫生体系的额外压力,加剧供求矛盾。基于医疗卫生资源配置结构性失衡视角研究“看病贵”与政府支出之间的关系发现:政府增加卫生支出会通过加剧人力资源配置的结构性失衡而加剧“看病贵”问题;只有将增加政府卫生支出与深化医疗卫生体制改革相结合,才能真正缓解全社会“看病贵”问题。因此,应深化公立医院改革,优化政府对医疗卫生资源的配置方式,加强基层医疗卫生体系建设,重塑医疗卫生服务治理模式,构建专业化治理模式,系统性重构中国医疗卫生领域人才建设。Expensive medical treatment(“Kan Bing Gui”in Chinese)refers to the high cost of converting medical and health resources into medical and health services,and the quantity and quality of medical and health service supply under limited resources are difficult to meet public health needs,thus directly affecting the construction of Healthy China Initiative.Moreover,the explosive growth in healthcare demand brought by the rapid aging of China’s population will create additional pressure on the healthcare system and exacerbate the mismatch between supply and demand.Consequently,solving the“Kan Bing Gui”problem is a crucial task to ensure the achievement of the goals of the Healthy China Initiative.Many related studies simply attribute the“Kan Bing Gui”problem to insufficient fiscal expenditure on health,which is inconsistent with the fact and lacks in-depth analysis of the underlying institutional mechanisms behind the problem.Based on the perspective of structural imbalance in the allocation of medical and health resources,this paper studies the relationship between“Kan Bing Gui”problem and fiscal expenditure on health.Firstly,by summarizing the characteristic facts,we condense two main theoretical hypotheses:(1)The imbalanced allocation of medical and health resources is a major contributor to the“Kan Bing Gui”problem;(2)An increase in fiscal expenditure on health will aggravate the structural imbalance in the allocation of medical and health resources and hinder the alleviation of the“Kan Bing Gui”problem.Secondly,we empirically confirm the above two hypotheses with provincial panel data from 2009 to 2019,using Feasible Generalized Least Squares(FGLS)and mediation testing.Finally,we conclude that increasing fiscal expenditure on health will ultimately worsen the structural imbalance in the allocation of human resources,which is not conducive to solving the“Kan Bing Gui”problem.For the sake of truly alleviating the“Kan Bing Gui”problem from the whole society,increasing fiscal expendit

关 键 词：健康中国 政府卫生支出 “看病贵” 资源配置失衡 医疗卫生体制改革 

分 类 号：R197.1[医药卫生—卫生事业管理]