【作者】 郑舒文；

【导师】 冯占春； 雷海潮；

【作者基本信息】 华中科技大学 ， 社会医学与卫生事业管理， 2008， 硕士

【摘要】 目的本研究通过分析我国卫生总费用(NHE)发展的特点、规律及影响因素。运用组合预测模型,实现对我国卫生总费用发展趋势的预测。以此为基础,重点讨论卫生总费用与国内生产总值(GDP)之间的关系,卫生总费用占GDP比例的重要意义与未来变动趋势,并与该值的国际水平相比较,进一步分析影响该比值今后发展趋势的主要因素,针对这些影响因素提出相关政策建议。方法本研究运用卫生事业管理学、卫生经济学、卫生政策管理学、卫生统计学等的理论和方法,对我国卫生总费用占GDP比例进行短期预测,进一步研究分析我国卫生总费用发展的特点、规律、影响因素及趋势。主要方法包括:⑴文献研究法;⑵规范分析法;⑶组合预测方法。应用Excel2000,SPSS11.5和Eviews等统计软件对数据进行分析测算。结果1.研究卫生总费用与GDP之间的关系后发现:(1)卫生总费用与GDP之间相辅相成,不可分割。1978年以来,两项指标在5%-15%的增长区间内迂回波动。这反映我国政府正在积极寻找一个发展平衡点,能够使卫生经济的发展与国民经济发展相适应,并协调发展。(2)卫生总费用在GDP中所占比例是反映国家对卫生关注度的重要指标。1978年以来,该指标在我国呈现波浪状上升,但增长速度迟缓。(3)与世界其它国家相比,我国正在用2%的世界卫生资源解决世界上22%人口的医疗卫生保健问题,反映了卫生资源的缺乏。根据经验,卫生总费用占GDP的比例控制在5%左右,弹性系数保持在1.2左右,比较符合中国的基本国情。2.卫生总费用占GDP比例的预测结果:(1)多元回归预测:该模型受外部环境影响较大,在假设条件不变的情况下,2006年的预测值为4.725%,2010年为4.944%。(2)ARMA模型:仅与时间变化相关,因此对历史数据拟合效果良好,得到2006年的预测值为4.589%,2010年为4.467%。(3)组合预测:综合利用每个模型的含带信息,建立组合预测模型,对未来五年我国卫生总费用占GDP的比例进行预测,2006年该比例预测值为4.641%,到2010年为4.648%。预测效果明显优于以上单项模型,可见预测值距离理想值5%有一定差距,表明国家对于卫生领域的投入总量不足。3.卫生总费用占GDP比例变动的影响因素有:(1)筹资结构的影响(2)人口老龄化的影响(3)疾病谱变化的影响(4)医学科技发展和卫生技术服务密集度的影响(5)药品消费的影响。4.对卫生总费用的发展提出政策建议:(1)增加政府卫生支出(2)建立覆盖全民的健康保障制度(3)加强慢性病的防治工作,降低患病率(4)鼓励患者利用适宜医疗技术和基层卫生服务设施(5)减少药品消耗量,降低药品费用占卫生总费用的比重。更多还原

【Abstract】 ObjectiveBy analyzing the feature,regulation and influencing factors of Chinese NHE,this research aims to forecast the trend of NHE with the aid of combination forecast model. On basis of this,the paper concentrates on the discussion of the relationship between NHE and GDP,the significance and future trend of the proportion of NHE in GDP,and the comparison of this proportion with international level. Then we further analyze the prime influential factors of this proportion will be made and propose the relative policy according to these factors.MethodsThrough the usage of theories and methods such as health service administration,health economics,health policy administration and health statistics,this paper makes a short-term forecast of the proportion of Chinese NHE in GDP as a whole,and further investigates the feature,regulation,influencing factors and trend of Chinese NHE. The main methods used in this paper include: (1) Literature Methodology; (2) Criterion Analysis Methodology; (3) Combination Forecast Methodology. Statistics software such as Excel2000,SPSS11.5 and Eviews are also used to analyze and calculate the data.Conclusion1. The research findings of the relationship between National Health Expenditure (NHE) and GDP: (1) There is an inseparable relationship between National Health Expenditure (NHE) and GDP: The two indicators range from 5% to 15% since 1978. This status reflects that our government is actively seeking a point of development balance in order to make the development of health economy adapt and coordinate the development of national economy. (2) The proportion of National Health Expenditure in GDP is a key indicator which reflects the extent the country is concerned about health. This indictor shows a wave—like in our country,however,growth retardation.(3) Our country uses 2% of the world health resource to solve medical and health care of 22% of the world population,which reflects our country lack of health resource. Based on experience,the proportion of National Health Expenditure in GDP should be controlled around 5% and elasticity coefficient should be maintained around 1.2,which relatively meets the essential situation of China.2. The influencing factors in variation on the proportion of NHE in GDP: (1) Financing Structure (2) Population Aging (3) Variation on Disease Spectrum (4) Development of Medical Science and Technology,Health Technique Service Concentration (5) Medicine Consumption.3. Forecast results on future trend of the proportion of National Health Expenditure in the GDP: (1) Multiple Linear Regression Model forecast: This model is greatly impacted by the external environment. Only if the assumed conditions don’t change,the predicted value of proportion of National Health Expenditure in GDP is 4.725% in 2006,and the predicted value is 4.944% in 2010. (2)ARMA Model forecast: this model is only related with time and the fitting degree of the ARMA model is very well. The predicted value of proportion of National Health expenditure in GDP is 4.589% in 2006 and the predicted value is 4.467% in 2010. (3)Combination Model forecast: make full use of the information of the two models to establish a combination model,which is used to forecast the proportion of National Health Resource in GDP in the future five years. The forecast result is the predicted value will increase from 4.641% in 2006 to 4.648% in 2010. There is still a certain gap between predicted value and ideal value,which shows the investment in health is inadequate in our country.4. Some proposals for the development of NHE: (1) increase government’s health service payout (2) establish the health insurance system for all the people (3) reinforce precautionary measures to prevent chronic disease and reduce morbidity (4) encourage utilization of suitable medical technology and basic-level medical facilities (5) reduce medicine consumption and lower the proportion of medicine expenses in NHE as a whole.更多还原