| 引用本文：王清波,杨莉.国家基本公共卫生服务财政投入：现状及省际差异双重分解[J].中国卫生政策研究,2025,18(11):1-8 |
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| 国家基本公共卫生服务财政投入：现状及省际差异双重分解 |
| 投稿时间：2025-05-01 修订日期：2025-05-15 PDF全文浏览 HTML全文浏览 |
| 王清波1,2，杨莉3,4 |
| 1.北京大学全球健康发展研究院 北京 100871;2.北京大学国家发展研究院 北京 100871;3.北京大学公共卫生学院 北京 100191;4.北京大学首都卫生与健康发展研究院 北京 100191 |
| 摘要:目的 了解国家基本公共卫生服务财政投入的现状及省际差异的演变趋势和来源。方法 基于2010—2024年国家和省级层面公开数据，采用按地区分解的基尼系数和按来源分解的基尼系数等方法，就相应要素对总体基尼系数的贡献率和边际贡献率进行双重分解。结果 全国基本公共卫生服务人均财政投入的总体基尼系数从0.12降至0.04，其中地区间差异的贡献率约为54.86%~63.74%；中央转移支付每增加1%，总体基尼系数约下降0.97%~2.09%。结论和建议：全国基本公共卫生服务财政投入在规模快速增长的同时，省际差异呈下降趋势，其中地区间差异的贡献率最高；中央转移支付对于缩小基本公共卫生服务人均财政投入的省际差异发挥着越来越重要的积极作用。建议建立基本公共卫生服务长效筹资保障体系和财政投入增长机制，动态优化财政投入的分配结构，加强新增项目的成本管理，探索基本公共卫生服务经费与其他经费合理统筹使用。 |
| 关键词:基本公共卫生服务 均等化 财政投入 中央转移支付 基尼系数分解 |
| 基金项目:国家科技重大专项（2024ZD0524500、2024ZD0524501）；国家自然科学基金项目（72174010） |
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| Fiscal investment in national essential public health services： Current status and dual decomposition of interprovincial disparities |
| WANG Qing-bo1,2, YANG Li3,4 |
| 1.Institute for Global Health and Development， Peking University， Beijing 100871， China;2.National School of Development， Peking University， Beijing 100871， China;3.School of Public Health， Peking University， Beijing 100191， China;4.Capital Institute of Health and Development， Peking University， Beijing 100191， China |
| Abstract:Objective To examine the current status of fiscal investment in national essential public health services and the evolution trends and sources of interprovincial disparities.Methods Using publicly available national and provincial-level data from 2010 to 2024， we employed region-decomposed Gini coefficients and source-decomposed Gini coefficients to conduct a dual decomposition of both the contribution rate and marginal contribution rate of relevant factors to the overall Gini coefficient.Results The overall Gini coefficient of per capita fiscal investment in national essential public health services declined from 0.12 to 0.04. Interregional differences accounted for approximately 54.86% to 63.74% of the overall Gini coefficient. A 1% increase in central government transfer payments is associated with an approximately 0.97% to 2.09% reduction in the overall Gini coefficient.Conclusions and Suggestions While fiscal investment in national essential public health services has grown rapidly in scale， interprovincial disparities have shown a declining trend， with interregional differences contributing the most. Central government transfer payments have played an increasingly significant role in reducing interprovincial disparities. It is recommended to establish a sustainable financing system and a dynamic fiscal investment growth mechanism， to optimize the allocation structure of essential public health service expenditures to enhance equity and efficiency， to strengthen cost management for newly added public health service items， and to explore integrated funding strategies to improve coordination between essential public health budgets and other healthcare financing streams. |
| Key words:Essential public health services Equalization Fiscal investment Central government transfer payments Decomposition of the Gini coefficient |
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