摘要
在医疗卫生体制改革中,"补供方"还是"补需方"的争论持续多年。这不但是决策者需要面对的重大政策问题,也是卫生经济学和医疗政策研究的重要理论问题。以福建省三明市为例,以公立医疗机构作为分析单位,研究地方财政对医院的补助、社会医疗保险的发展与医疗费用增长之间的关系。研究发现,财政补助占收入比重高的医疗机构的次均费用更可能低于财政补助比重低的机构;而医保的壮大与医疗机构费用增长之间没有显著关系。"补供方"和"补需方"的选择意味着寻找政府管理和第三方机构经办的平衡点。就三明市而言,政府补助对于医疗机构费用控制的作用表明,通过"补供方"的经济杠杆效应控制医疗费用的过快增长仍有很大潜力,"补供方"和"补需方"的平衡点需要进一步挖掘。
In the reform of medical and health system,the depute about either"aiding the supplier"or"aiding the demander",which is not only a significant policy issue the policymaker need to face but also an important theoretical issue for the study of health economics and healthcare policy,has been going on for several years.Taking Sanming City in Fujian Province as an example and public medical institution as unit of analysis,this article studies local financial aid to hospitals and the relationship between the development of social medical and healthcare insurance and the increase of medical expense,which finds that the average hospitalization expenses in the medical institution with its financial aid accounting for a high proportion of income may be more likely to be lower than the ones in the institution with low proportion of financial aid;while there is no significant relationship between the expansion of medical and healthcare insurance and the increase of the expenses of medical institutions.The option of"aiding the supplier"or"aiding the demander"means to find a balance between government administration and the third-party agency handling.With regard to Sanming City,the effect of government aid to the control of medical institution expense indicates that controlling the rapid growth of medical expenses by domino effect of the economic leverage of"aiding the supplier"is still great potential,while the balance between"aiding the supplier"and"aiding the demander"need to be examined further.
出处
《北京行政学院学报》
CSSCI
北大核心
2017年第6期10-17,共8页
Journal of Beijing administration institute
基金
国家社会科学基金青年项目(16CSH032)
关键词
财政补助
医疗卫生体制改革
公立医院改革
医疗保险
三明市
financial aid
medical and healthcare systems reform
public hospital reform
medical insurance
Sanming
