中国公共卫生财政支出分析  

Analysis on China s fiscal expenditure for public health

作　　者：朱坤 ZHU Kun(Chinese Academy of Fiscal Sciences,Beijing 100142,China)

机构地区：[1]中国财政科学研究院,北京100142

出　　处：《中国卫生政策研究》2024年第5期33-40,共8页Chinese Journal of Health Policy

基　　金：国家社会科学基金项目(20STA059)。

摘　　要：本文对我国新医改以来的公共卫生财政支出进行分析,发现主要存在以下问题:一是公共卫生纵向与横向投入不协同,不利于提升专业公共卫生机构在我国公共卫生体系中的地位;二是公共卫生领域的事权与支出责任划分,不利于“预防为主”目标的实现;三是专业公共卫生机构在卫生服务体系中的地位日益弱化,与“预防为主”的要求不相适应;四是人员激励不足,进一步弱化了专业公共卫生机构。据此,本文提出四点政策建议:一是提高公共卫生预算的优先层级,强化公共卫生财政支出的硬约束;二是优化公共卫生财政支出结构,加强公共卫生纵向投入与横向投入的协同;三是完善公共卫生领域的中央和地方事权与支出责任,增强中央财政在横向投入中的支出责任;四是进一步健全人员激励机制,稳步强化专业公共卫生机构。This paper analyzed the fiscal expenditure on public health since the new healthcare reform in China and found that many issues existed in China s public health system as below:firstly,there is no coordination between vertical and horizontal investment in public health,which is not conducive to enhancing the position of professional public health institutions in China s public health system;Secondly,the division of powers and expenditure responsibilities in the field of public health is not conducive to achieving the goal of“prevention priority”;Thirdly,the position of professional public health institutions in the health delivery system is increasingly weakening,which is not in line with the requirement of“prevention priority”;Fourthly,insufficient personnel motivation is quite common,further weakening professional public health institutions.In response to the above issues,four recommendations are proposed.Firstly,increase the priority level of public health budget and strengthen the hard constraints of fiscal expenditure on public health;secondly,optimize the structure of public health expenditure and strengthen the synergy between vertical and horizontal investment in public health;thirdly,improve the central and local powers and expenditure responsibilities in the field of public health,and enhance the expenditure responsibility of the central government s horizontal investment;fourthly,further improve the personnel incentive mechanism and steadily strengthen professional public health institutions.

关 键 词：公共卫生财政支出 事权与支出责任 纵向投入 横向投入 

分 类 号：R197[医药卫生—卫生事业管理]