2016—2022年贵州省预防服务费用筹资与使用情况分析  

Analysis of the financing and utilization of preventive service costs in Guizhou Province from 2016 to 2022

作　　者：吕轶娟 陶婉菊 王清华 叶莉[2] 张科[2] 苏旭 王飞清 王聪 史华 LV Yi-juan;TAO Wan-ju;WANG Qing-hua;YE Li;ZHANG Ke;SU Xu;WANG Fei-qing;WANG Cong;SHI Hua(The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine Guiyang,Guizhou 550001,China;不详)

机构地区：[1]贵州中医药大学第一附属医院,贵州贵阳550001 [2]贵州省疾病预防控制中心,贵州贵阳550001

出　　处：《现代预防医学》2024年第21期3923-3928,3954,共7页Modern Preventive Medicine

基　　金：国家自然科学基金项目(81560559);贵州省科技计划项目(黔科合支撑[2022]一般181);贵州省中医药管理局(QZYY-2018-018);贵州省卫生健康委卫生费用核算项目;贵阳市科技计划项目筑科合同([2019]9-2-40号)。

摘　　要：目的 分析2016—2022年贵州省预防服务筹资与使用情况,为提高预防费用筹资结构韧性和可持续性,优化预防服务功能结构提供参考依据。方法 基于卫生费用核算体系2011(SHA2011),从总体预防服务费用、筹资方案、服务功能及机构流向维度,对贵州省2016—2022年预防服务费用进行分析。结果 2016年贵州省预防服务费用为37.2亿元,2022年增加到100.56亿元,占经常性卫生费用的比例从5.07%上升到8.49%。在2020年,传染病防治费用占比上升至14.71%,但慢性病管理、儿童健康服务和孕产妇保健的比例在2020年有所下降。7年间政府方案及家庭卫生支出有所下降,企业筹资占比大幅上升;医院和基层医疗机构预防服务费用占比逐年上升,从48.59%上升到67.29%。结论2016—2022年贵州省预防服务费用及占经常性卫生费用比重有所提高,但“轻预防,重治疗”的现象还比较明显;医院、基层医疗机构及公共卫生机构是各类预防服务的主要提供机构,存在“以医养防”的现象;预防服务费用中个人现金支出比例逐步降低,但政府及社会卫生筹资投入仍然不足,且筹资结构易受到突发短期因素及长期因素影响。Objective To analyze the financing and utilization of preventive service costs in Guizhou Province from 2016 to2022,providing reference for improving the resilience and sustainability of preventive funding structures and optimizing the functional structure of preventive services.Methods Based on the System of Health Accounts 2011(SHA2011),this study analyzes the preventive service costs in Guizhou Province from the dimensions of total preventive service costs,financing schemes,service functions,and institutional flows.Results The preventive service costs in Guizhou Province were 3.72 billion yuan in 2016,increasing to 10.056 billion yuan by 2022,with the proportion of these costs in recurrent health expenditures rising from 5.07% to 8.49%.In 2020,the proportion of expenditures on infectious disease prevention and control increased to 14.71%,while the shares for chronic disease management,child health services,and maternal health care de-creased.Over the seven years,government programs and household health expenditures declined,while corporate financing significantly increased.The proportion of preventive service costs attributed to hospitals and grassroots medical institutions rose annually from 48.59% to 67.29%.Conclusion From 2016 to 2022,the preventive service costs and their share of recurrent health expenditures in Guizhou Province increased;however,the phenomenon of “less attention on prevention and much attention on treatment” remains evident.Hospitals,grassroots medical institutions,and public health agencies are the primary providers of various preventive services,reflecting a trend of “medical care supporting prevention”.The proportion of personal cash expenditures in preventive service costs gradually decreased,but government and social health funding remains insuf-ficient,and the financing structure is vulnerable to short-term and long-term external factors.

关 键 词：预防服务费用 SHA2011 筹资来源 服务功能 机构流向 

分 类 号：R197.1[医药卫生—卫生事业管理]