【摘要】 目的:根据部分OECD国家卫生总费用的数据,推算我国卫生总费用占国内生产总值的水平。方法:选取遵循"卫生账户测算体系(SHA)的部分OECD国家为研究样本,根据文献确定影响卫生总费用的各类社会经济、人口卫生等因素,采用人工神经网络方法训练卫生总费用与影响因素之间关系的数量模型。在此基础上推算我国卫生总费用占GDP的比例。结果:人工神经网络分析得到1995~2003年我国卫生总费用占GDP的比例分别为:5.10%、5.20%、5.30%、5.41%、5.47%、5.49%、5.53%、5.94%和6.11%。模型推算结果与其他有关工作组的卫生总费用统计测算结果趋势一致,但费用水平稍高于后者。模型推算结果也与WHO对我国卫生总费用水平的估算结果相近。结论:国内对于我国卫生总费用的统计测算距离SHA的要求有差距,可能存在统计口径偏窄,测算水平偏低的问题。建议尽快根据SHA的方法测算我国卫生总费用,以增强测算结果的国际可比性。同时,提出了对改善我国卫生系统绩效的政策建议。更多还原

【Abstract】 Objective: Purpose of this paper is to re-examine the ratio of National Health Expenditures (NHE) to GDP in China based upon data from some OECD countries using the System of National Health Accounts(SHA). Methods: Some OECD countries adopting the SHA were selected as a sample. Literature review was used to define the relevant social - economic and demographic factors associated with the NHE. Artificial Neural Network (ANN) was used to establish ratios of NHE/GDP of China were calculated and presented by using ANN with the relationship between the ratio of NHE/GDP and the factors, thereafter; the Chinese input variables. Results: ANN showed that China’s NHE/GDP in the year of 1995 to 2003 were 5.10% , 5.20% , 5.30% , 5.41% , 5.47% , 5.49% , 5.53% , 5.94% and 6.11% respectively. These results were consistent in trend with the figures reported by other working groups, but somehow higher. The results were very close to the estimated figures generated by World Health Organization (WHO). Conclusions: China’s NHE accounting method is different from SHA and NHE might be underestimated due to the narrow scope in accounting. It is suggested that SHA be adopted as quickly as possible in China so that the NHE results could be international comparable. Some policy suggestions on improving the health system performance in China were also discussed.更多还原