中国农村贫困地区卫生总费用时间序列系统分析

本文运用宏观卫生经济核算的方法，按照卫生总费用分配流向，整理测算了1978－1993年中国农村贫困地区卫生总费用时间序列的数据并对测算结果进行了政策分析。测算结果发现，贫困的农村地区卫生发展迟缓，与全国平均水平比较，差距在明显扩大；贫困地区在人均国内生产总值水平只有全国平均水平的30％的情况下，投了4．6％的国内生产总值发展卫生保健服务。即使如此，贫困地区居民医疗消费的实际支付能力与当地医疗机构的收费额度相比较，差距日益扩大。在现有支付能力下，贫困农民根本不可能从医疗机构得到基本的卫生保健服务。一方面，是贫困农民医疗需求不足；另一方面，贫困地区医疗机构供给相对有余，效率低下人浮于事。在我国贫困地区卫生费用对农民人均纯收入的多少竟然缺乏弹性，说明贫困地区温饱问题尚未解决。因此，很难指望贫困农民在温饱与健康的选择中，放弃温饱而选择健康。作者认为，农村居民基本卫生服务的实现程度，农村居民大病住院医疗的保障程度，是农村贫困地区卫生行政的主要责任。

Systems analysis on total health expenditures by time ranking in the Chinese poor rural areas

This papers shows the total health expenditures by time ranking in the Chinese poor rural areas 1978 ~ 1993, andpolicy analysis by macro health economics and allocation of total health expenditures . It shows that health service developed slowly inthe poor rural areas, and there is an increasing distance with the natiotal average level of development. Although local GDP onlyamounts to 30% of the naional aveop level, the for gnearent input 4.6% of GDP to expand health care. Even so, the residents' affordability of consumption for health are is far away form the local chargr for health care. Under present affordability thepoor formers are unable to get basic health ere for health facilihes. Supply of health forilihes in poor area seems relatively surpluswith inefficiency and overstaffed , while the farmers in poverty are short of demand for health care. In the Chinese poor area, healthexpenses are leck of elashcity to the ne income per capita. It shows that while the problem of enough foof and clothing has not fullybeen solved, there is little possibility for the poor farmers to choose health as priority. The authors suggest that it be the essential responsibility for the local government to provide basic health care and inpatient ere with catastrophic diseases to residents in the poorrural areas .