【作者】 吴昊；

【导师】 孙克竞；

【作者基本信息】 东北财经大学 ， 财政学， 2016， 硕士

【摘要】 公共卫生事业的建设与投入是居民获得健康的重要社会保障,是关系到国家和社会长治久安的重大民生问题。近年来,各国各地区传染病爆发频繁,国际上对公共卫生领域的关注程度不断加深,为推进公共卫生事业的发展,我国政府推出了新一轮的医疗卫生改革方案,以实现到2020年“人人享有基本医疗卫生服务”的目标。在政府政策的主导下,我国各地区公共卫生投入规模呈现不断扩张的趋势,但也应注意到,政府的公共卫生投入最终目标是要满足辖区居民公共卫生服务的需求,资源的有限性决定了政府对公共卫生领域的投入规模不能无休止的增长,服务型政府的目标和资源的稀缺性要求政府的公共卫生支出必须高效,因此有必要对辖区财政公共卫生投入进行绩效评价与管理。对辖区财政公共卫生投入进行绩效评价,一方面是对财政公共卫生支出绩效评价理论体系的完善,另一方面也能检验现行财政公共卫生投入的绩效现状,作为提高财政公共卫生支出绩效的基础。为提高政府公共卫生服务的供给效率,国外内诸多学者基于不同的时代背景和研究方法,结合自身研究的学科基础对财政公共卫生投入的绩效水平进行了深入的研究并取得了显著的成果。本文以已有研究成果为基础,以实证研究方法为主要手段,对辖区财政公共卫生投入绩效评价问题进行分析。本文主要按照提出问题——基础理论分析——实证模型构建——结论与政策建议的研究思路对辖区财政公共卫生投入绩效问题进行分析。实证模型的分析方法是本文研究的核心手段,多元回归模型的构建是对以往比率分析研究方法的延伸和发展。理论模型以因子分析为基础的综合绩效指标代表辖区财政公共卫生投入的绩效水平,在市场经济环境下考虑地方政府的财政制度建设、人口结构、地方政府收入对财政公共卫生投入满足程度等因素的影响。基于以上分析构建生产函数形式的绩效模型,选取因子分析得出的综合指标作为辖区卫生投入绩效的衡量指标,主要通过公共服务需求与财政公共卫生投入关系、财政透明度、市场化程度、人口规模与结构四方面因素构造模型影响因素。理论模型构造完成后,本文对理论模型进行基础数学变换与推导,并对变换后模型中影响财政公共卫生投入绩效的因素进行分析,提出假设推论。通过最终的实证检验和分析,作者认为,财政透明度、市场化水平、宏观税负水平和人口规模都是影响辖区财政公共卫生投入绩效的显著性因素。其中,市场化水平与财政公共卫生投入绩效呈现反向变动趋势；财政透明度、宏观税负水平和人口规模对财政公共卫生投入绩效有正向影响作用。本文结合实证结果与进一步的理论分析提出加强辖区财政公共卫生投入绩效的政策建议,包括保障地方政府财政公共卫生投入规模；完善地方税体系,创造相对合理的宏观税负环境；推进地方预算管理制度进程,提高财政透明度；合理划分政府与市场在卫生事业建设中的边界,理顺政府与市场关系等。本文研究成果主要在于以下两个方面：一是研究视角的创新。本文结合以往对财政公共卫生供给和公共卫生需求的研究,在新供给经济学等理论的基础上,以医疗卫生投入对辖区公共服务需求的满足程度作为卫生投入绩效基本影响因素,把制度背景和市场化环境也纳入分析之中,以全新视角对辖区财政公共卫生投入绩效进行分析。二是利用面板数据构建多元回归方程。面板数据从时间和个体两个方向对数据进行描述,以多元回归的方法进行模型构建,是对传统时间序列数据统计描述的发展,评价模型应用简便可操作性强且具有稳定性,为优化辖区财政公共卫生投入实践提供实证依据。更多还原

【Abstract】 In the present age, with the improvement of living standards, the medical and health care work is playing an important way in our society. The fundamental of human Medical and health work is the foundation of people’s health, it is also a major livelihood issue related to peoples long-term stable development of our country and society. In recent years, the infectious diseases outbreak in many countries, therefore, the international health’s care department pays more and more attention to this issue. Our government launched a new round of health care reform in order to increase the development of medical and health undertakings, aiming at "everyone to enjoy basic medical health services" in 2020. However, on the other hand, the government expenditure budget is limited of medical and health investment in China. Therefore, it is necessary to carry out the performance evaluation of financial health investment within the jurisdiction. It can enrich the performance evaluation theory of fiscal health expenditure; in other sentence, it also can test the performance of the current financial health expenditure and put forward the measures to improve the performance of financial health expenditure.Rely on the remarkable achievements gained by scholars at home and abroad on the performance of financial health investment, taking the empirical research method mainly, this paper attempts to construct the performance analysis model of financial health expenditure by simple performance index, in order to achieve the goal of improving the level of financial health investment performance. The influencing factors of the model include the measurement of the performance of health investment, the relationship between public service demand and financial health investment, government transparency and market degree, according to which put forward the corresponding policy recommendations.Through the transformation, analysis and hypothesis testing of the model, this paper obtains the influencing factors of the financial health investment performance, including the relationship between local tax revenue and fiscal health expenditure growth, government transparency, market level, macro tax burden level, in which the first factor has a positive effect on the performance while the following three factors have a positive effect. According to the result, this paper put forward some policy recommendations to improve the financial health of investment performance.This assignment mainly issue in the following two parts. Firstly, it provides a new angle of view on the research. This paper analyzes the performance of the financial health area through a brand new view rely on previous studies and the theory of new supply economics. Moreover, this paper applies the panel data multivariate regression method. The data are described through two directions of time and individual while the model is constructed by the method of multiple regressions. It is a development of traditional time series data statistical description. The evaluation model is simple and it can be enforce it in our society.更多还原