医疗床位及相关资源供给趋势分析：基于中美对比分析思考我国医疗卫生领域的供给侧改革

目的:对比分析中美两国床位、医生数和医疗服务利用等变化趋势和差异,为我国医疗卫生领域供给侧改革提供政策启示。方法:采用描述性分析方法,分析OECD、美国疾病与控制中心、"中国卫生与计划生育统计年鉴"中关于床位、医生、住院和门诊服务利用等数据。结果:我国每千人口床位数已经超过美国,每千人口医生数低于美国;中美两国门诊人次均呈逐年增长趋势,但入院人次美国逐年下降,我国逐年增长;我国入院人次增长速度高于门诊人次增长速度。结论:病床数减少和门诊量增加是美国医疗资源和服务利用的主要变化趋势;我国医疗资源供给结构失衡致住院服务过度利用。建议我国在医改卫生供给侧改革中,力推"三医联动",将改革思路调整为从"资源量"转向"服务质提"、卫生管理体制从"以疾病为中心"转向"以健康为中心"。

The trend of hospital bed and related resources -- based on the comparative analysis between China and the United States

Objective: To compare the trends of the number of beds, doctors and health care utilization between China and the United States , so as to provide some implications for the health care reform in China from the supply side. Methods: The data from the website of OECD and CDC of the United States as well as Chinese Statistical Yearbook of Health and Family Planning were used to describe the trends. Results: The beds per 1000 people in China has exceeded that of the United States, but the doctors per1000 people was less. Both countries have seen an increasing trend of outpatient visits. However, in the America the hospitalization is decreasing while in China it is increasing. Particularly, in China the growth rate of hospitalization is even higher than the outpatient visits. Conclusion: Though there is an increasing trend of outpatient visits in both countries, the United States is able to reduce the hospitalization while the overuse of hospitalization is serious in China. It may imply that China should transform from the disease-centered care to health-centered care and put more emphasis on the improvement of the quality of care