2015年上海市卫生总费用核算结果及特点分析

从筹资总量来说，2015年上海市卫生费用（来源法）总额为1536.6亿元，占GDP的比重为6.1%，人均卫生总费用为6362.0元。从筹资结构来说，上海市卫生总费用来源以社会卫生支出为主（占总费用57.4%），政府卫生支出和个人卫生支出占比分别为20.8%和21.8%。从机构分配来说，同期上海市卫生费用（机构法）总额为1722.5亿元，其中医疗机构费用占比高达85.2%。总体来说，2015年上海市卫生总费用增长较快，个人现金卫生支出占比水平稳定，医院费用仍为卫生总费用的最主要机构流向。卫生总费用占比首次突破6%，在当前经济形势下要一体化推进医药卫生机制改革，通过实施分级诊疗、深化公立医院综合改革等举措将医疗费用上升控制在合理范围内，同时鼓励商业保险，多渠道筹资，确保资金可持续发展。

Analysis of the Results and Characteristics of Total Health Expenditure on Health in Shanghai in 2015

In terms of the total volume of health financing, the total health expenditure (THE) (by source) in Shanghai in 2015 was 153.66 billion yuan, accounting for 6.1% of GDP, and the total health expenditure per capita was 6362.0 yuan. In terms of the financing structure, the health financing in Shanghai was mainly from social health expenditure (accounting for 57.4% of the THE). Government health expenditure and out-of-pocket(OOP) expenditure accounted for 20.8% and 21.8% of THE in Shanghai respectively. In terms of the institutional allocation, the THE (by organization) in Shanghai over the same period was 172.25 billion yuan, of which the medical institutions accounted for up to 85.2%. Overall, the THE in Shanghai increased substantially in 2015. The proportion of OOP stayed stable and the hospitals remained the main institutions where health expenditure allocated. In 2015, the proportion of THE in GDP for the first time exceeded 6%. In the current economic situation, it was suggested to promote the integrated health system reform through implementing hierarchical diagnosis and treatment, deepening the comprehensive reform of public hospitals and other initiatives with the aim of controlling the rise of medical expenditure within a reasonable range, while encouraging the development of commercial insurance and diversifying the financing sources to ensure the sustainable development of the health financing of Shanghai.