2012年上海市卫生总费用核算研究

摘要

卫生费用核算是国际上衡量卫生筹资的宏观指标，上海市于2008年启动该项工作，并已将卫生费用核算纳入常规核算工作。2012年，上海市卫生总费用（来源法）已达到1092.4亿元人民币（“元人民币”以下简称“元”），占上海市生产总值（GDP）的比重为5.4%，人均卫生总费用为4589元。从筹资结构来看，政府卫生支出占21.3%，社会卫生支出占59.2%，个人现金卫生支出（OOP）占19.5%。总体来说，近年来上海市卫生筹资呈现充足程度提高、筹资结构相对合理、可持续性较好的特点，但同时面临筹集资金使用率不足、部分人群医疗负担过重等问题，建议合理引导和控制卫生总费用增长，统筹卫生资金，提高资金使用效率，针对重点人群“靶向”减负等措施，切实减轻居民医疗负担，提高居民健康水平。%Health accounts is a macro method which has been widely applied to measure health financing internationally. Shanghai has launched the health accounts research project since 2008,and it has been included in routine work. In 2012,Shanghai total expenditure on health(TEH)reached 109.24 billion yuan RMB,accounting for 5.4% of gross domestic product(GDP),and TEH per capita was 4 589 yuan RMB. From the perspective of financing structure,government expenditure on health accounted for 21.3%,social expenditure on health accounted for 59.2%,and out-of-pocket payment(OOP)accounted for 19.5%. Overall,in previous years,Shanghai health financing presented some characteristics of the improvement in adequacy,financing structure and sustainability,while it also faced the problems of insufficient use of funding and heavy burden of medical expense in some population groups. Four interventions are suggested as follows:rationally guiding and controlling the increasing of TEH,integrating health funding,improving efficiency of funding use,and targeting the focus groups and releasing the burden of medical expense. It is expected that these measures could release residents’ burden of medical expense,and improve people health.