政府卫生筹资政策执行力对医疗费用影响的研究

目的定量分析政府筹资功能的执行力与城乡医疗机构的医疗费用上涨之间关系。方法采用带观测变量的结构方程模型（PA-OV模型）构建政府筹资政策执行力与医疗费用之间的经济学模型。结果①医疗费用上涨的根源在于政府投入不足,特别是对城市医院的投入不足,如国家对城市医院财政投入增加1亿元,城市医院总医疗费用将下降39.567亿元;财政投入占乡镇卫生院医务人员工资比例上升1%,人均医疗费用下降0.595元;②政府投入不足根源为政府筹资政策执行力不足,政策执行进程未与社会发展战略同步。政策执行力不足在政府、医院和医生等不同利益群体均有体现,而根源在于政府卫生筹资政策的执行力不足。结论要有效控制医疗费用上涨,目前关键在于提高政府卫生筹资政策执行力,具体表现为增加政府财政投入,特别是增加对城市医院的投入。

Study on the Government Health Financing Policy Executive Force Affecting Medical Costs

Objective To study the relationship between execution of government funding function and the rising cost of medical treatment in urban and rural medical institutions.Methods Using the observation variable structure equation model to analyze rising medical costs influence factors.Results(1) Medical treatment fee increase root lies in the lack of government’s input,especially for urban hospital insufficient investment.If state financial input in urban hospitals increase by 1 billion,the total medical costs of urban hospitals will drop 39.567 billion;financial investment accounted for the proportion of rural hospitals in medical staff salaries is increased by 1%,per capital health care costs will drop 0.595 yuan.(2) The source lack of government’s input is government funding policy executive power shortage and policy implementation process does not synchronize with social development strategies.Conclusion To effectively control rising health care costs,the current work is to enhance the government health financing policy execution,specific performance increase government investment,particularly to increase investment in urban hospitals.