基于“卫生费用核算体系2011”的人群就医负担国际比较  

International Comparison of the Medical Economic Burden among Populations Based on System of Health Accounts 2011

作　　者：王苗 柴培培 Wang Miao;Chai Peipei(College of Health Services and Management,Shanxi University of Chinese Medicine,Taiyuan,030619,China)

机构地区：[1]山西中医药大学健康服务与管理学院,太原030619 [2]国家卫生健康委卫生发展研究中心,北京100044

出　　处：《中国卫生经济》2024年第5期72-78,共7页Chinese Health Economics

基　　金：国家自然科学基金资助项目(72004041);山西省科技战略研究专项(202204031401164)。

摘　　要：目的:基于“卫生费用核算体系2011”,剖析国内外人群就医经济负担差异及成因,为我国居民就医经济风险保障政策的完善提供参考。方法:收集经济合作与发展组织成员国及我国的经常性卫生费用数据,运用描述性统计探究人群就医经济负担与医疗保障制度、卫生服务体系之间的关系。结果:2020年,经济合作与发展组织成员国的个人卫生支出占家庭消费支出比重平均为3.00%,我国此比重为5.24%;我国公共筹资占经常性卫生费用比重为54.81%,低于经济合作与发展组织成员国平均水平;经济合作与发展组织成员国的个人卫生支出主要用于医疗用品和门诊服务,我国个人卫生支出主要用于门诊服务和住院服务。结论:医疗保障制度的差异是就医经济负担分布不均衡的重要因素;卫生服务供给体系是减轻民众就医经济负担的基础,完善的分级诊疗服务体系可合理引导医疗服务需求,“防—诊—控—治—康”协同服务链是缓解就医经济负担的根本。Objective:Based on“the System of Health Account 2011”,it aimed to analyze the differences and causes of the medical economic burden between domestic and foreign population,and provide reference for the medical economic risk protection policies in China.Methods:Data of recurrent health expenditure of China and OECD member states were collected and descriptive statistical analysis was used to explore the relationship between the population's economic burden of medical treatment and medical security system and health service system.Results:In 2020,the average proportion of personal health expenditure in household consumption expenditure in OECD member countries was 3%,and the proportion in China was 5.24%.In China,public financing accounted for 54.81%of recurrent health expenses,which was lower than the average of OECD member states.Personal health expenditure of OECD member states was mainly spent on medical supplies and outpatient services,and China's personal health expenditure was mainly spent on outpatient services and inpatient services.Conclusion:Difference of medical security system is the important factor of the uneven medical burden.An appropriate health service delivery system is the basis to reduce the medical economic burden,a perfect hierarchical medical service system can guide the demand for medical service,and the collaborative chain of“prevention-diagnosis-control-care-rehabilitation”is fundamental to alleviate the medical economic burden.

关 键 词：卫生费用核算体系2011 医疗经济负担 卫生支出 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F014.4[经济管理—政治经济学]