政府医疗卫生投入模式评估与优化路径  

Government Health Care Investment Model Assessment and Path Optimization

作　　者：樊敏杰 杨蕊 刘源 FAN Minjie;YANG Rui;LIU Yuan(School of Public Finance and Taxation,Henan University of Economics and Law,Zhengzhou 450046,China)

机构地区：[1]河南财经政法大学财政税务学院,郑州450046

出　　处：《开发研究》2024年第3期88-99,共12页Research On Development

基　　金：河南省高校人文社会科学研究一般项目“财政‘紧平衡’约束下河南省政府多维医疗卫生投入绩效及其提升路径研究”(2025ZZJHI77);河南省高等学校青年骨干教师培养计划“新型城镇化背景下农村劳动力迁移问题研究——基于健康人力资本的视角”(2020GGJS116)。

摘　　要：在政府医疗卫生投入路径多元化的背景下,如何在保证投入规模的前提下合理引导资金流向并对其进行绩效评估,关乎未来政府医疗卫生投入的结构性优化。利用2010—2020年中国家庭追踪调查(CFPS)的面板数据,基于条件混合过程(CMP)两阶段模型,从“补供方”“补需方”和“强基层”3个层面分别对政府医疗卫生投入的健康绩效、经济绩效和医疗服务供给绩效进行考察。研究结果显示,政府不同流向的资金投入均有利于改善居民健康状况。“补需方”有利于降低自付费用进而降低患者的医疗负担,而“补供方”则会加重患者的医疗负担。“补需方”和“补供方”会显著提升患者的主观医疗评价,而患者的医疗服务利用率提升则主要依靠政府的需方投入和基层投入。异质性结果显示,政府医疗卫生投入在健康绩效和医疗服务供给绩效两个方面存在城乡和区域差异,在农村和中西部地区,“补需方”“补供方”“强基层”对健康绩效和医疗服务供给绩效的提升效应更强。基于此提出增加基层投入力度和“补需方”力度、优化医疗资源配置、完善医疗卫生制度配套措施等优化路径,切实保障居民健康权益。Against the background of diversified government health care investment paths,how to reasonably guide the flow of funds and evaluate the performance of different investment paths under the premise of ensuring the scale of investment is related to the structural optimization of government health care investment in the future.Utilizing panel data from the China Family Panel Survey(CFPS)from 2010 to 2020,based on a two-stage model of the Conditional Mixed Process(CMP),this paper examines the health performance,economic performance and medical service supply performance of government healthcare investment from three perspectives:of the“supply-side subsidy”,the“demand-side subsidy”and“strengthening grass-roots level”.The research results show that the governments funding in different directions is conducive to significantly improving residents’health status.“Demand-side subsidy”is beneficial to reducing the patient’s out-of-pocket medical expense and thus reducing the patient’s medical burden,while“supply-side subsidy”is the opposite.Both“demand-side subsidy”and“supply-side subsidy”significantly improve patients’subjective medical evaluation,while the improvement of patients’medical services utilization rate mainly depends on government demand-side subsidy and grass-roots investment.Heterogeneity results show that there are differences in health performance and medical service supply performance of government health care investment between urban and rural areas and different regions.In rural areas and central and western regions,“demand-side subsidy”,“supply-side subsidy”and“strengthening grass-roots level”have shown stronger effects on improving health performance and medical service supply performance.Based on this,this paper proposes to increase the grassroots investment and“demand-side subsidy”,optimize the allocation of medical resources,improve the supporting measures for the medical and health care system and other optimization paths to effectively protect r

关 键 词：医疗卫生 政府多维投入 综合绩效 优化路径 

分 类 号：R197[医药卫生—卫生事业管理] F127[医药卫生—公共卫生与预防医学]