| 引用本文：俞卫.医疗卫生服务均等化与地区经济发展[J].中国卫生政策研究,2009,2(6):1-7 |
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| 医疗卫生服务均等化与地区经济发展 |
| 投稿时间：2009-05-16 修订日期：2009-05-21 PDF全文浏览 HTML全文浏览 |
| 俞卫 |
| 上海财经大学公共经济与管理学院 |
| 摘要:改善城乡和地区间医疗服务的差异是我国医改政策的一个重要任务。本文从地方政府之间财政能力的差异角度分析推进医疗卫生服务均等化的难点和相应的对策。作者首先分析了地区经济差异与医疗保障水平、资源配置和健康之间的相关性，然后通过一个模拟的理想筹资水平分析了实现医疗卫生服务均等化对地方财政的压力，以及缩小地区财政压力的必要条件。研究发现，我国医疗保障水平和健康指标同地方经济水平密切相关；对于一个平均的保障筹资水平，要做到70%的投入（普遍接受的公平社会投入），大多数地方政府都无法承受；更重要的是，改善地区经济差异的必要条件是落后地区的经济增长速度要高于发达地区，这个条件在过去十几年内不但没有出现而且还在反向发展。因此作者建议医疗卫生服务均等化的政策应该充分考虑地区经济差异的客观条件，采取中央统筹儿童、青少年的大病，地方改善基本医疗卫生服务的两条腿策略可能是一个更好的均等化方针。 |
| 关键词:卫生改革 医疗卫生服务均等化 地区经济差异 财政政策 |
| 基金项目:上海财经大学“211工程”三期重点学科建设项目和上海浦江人才项目 |
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| Equality in health service and regional economic development |
| YU Wei |
| School of Public Economics and Administration, Shanghai University of Finance and Economics |
| Abstract:An important task of Chinas health system reform is to improve disparity in health service between rural and urban areas as well as among regions. This article analyzes the difficulty of achieving this objective due to economic disparity. It first presents the association of local GDP with the level of health insurance, resource allocation, and health. By investigating the financial burden to local governments if they contribute 70% of the premium (a common consensus for a equitable share of society) for an average level of medical care. The results indicate that most local governments could not afford the desired financing target. Most importantly, the necessary condition to improve economic disparity is that underdeveloped regions grow faster than developed regions. This condition not only has not occurred during the last decade, but moving toward an opposite direction. Therefore, the author suggests that the policy to improve health equity should fully consider the fact of persistent economic disparity among regions and take a paired strategy: the central government provides a universal plan to cover children for catastrophic medical conditions and local governments improve essential health care, which could be a better policy to the society |
| Key words:Health system reform, Health equality, Regional economic disparity, Fiscal policy |
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