The temporal and spatial interpretation of China's health financing: what do Chinese' government 'do' in new healthcare reform?

IF 2.7 3区 经济学 Q1 ECONOMICS Health Economics Review Pub Date : 2024-09-17 DOI:10.1186/s13561-024-00551-1
Na Wang
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Abstract

Objective: The analysis of health expenditure and its structure takes on a critical significance in national health policy research, and the public welfare of national health undertakings can be manifested by the government's investment in health. In this study, the aim was to analyze total health care costs, the structure of health financing, and the government's investment in health, so as to provide a reference for China's health policy adjustment.

Methods: Description and cluster analysis were conducted using R language to analyze total health care costs and the structure of health financing of 31 regions in China between 1990 and 2020 to gain insights into the temporal and spatial changes total health care costs and the structure of health financing in China. The government's investment in health was analyzed using description and abundance heatmap to know the temporal and spatial changes of the government's health investment.

Results: The total health expenditure per capita reached 5112.3 yuan in 2020, and the total health expenditure accounted for 7.10% of GDP. The government health expenditure took up a significantly lower share of the total health expenditure in 1993-2006 (17.09% [16.30,17.88]), whereas it has been nearly 30% (29.56% [28.73,30.3]) over the past few years. As to 31 regions in China, the government health expenditure per total health expenditure reached 67.94% in Tibet, whereas a level of 27.866% (25.629-30.103) were maintained in other regions. Beijing and Shanghai have achieved over 50.00% of social health expenditure per total health expenditure in recent five years, it was significantly higher than other regions. The per capita government expenditure as a fraction of GDP of Tibet (6.842%) was the highest region in 2011-2019, while Jiangsu (only 0.937%) was the lowest region.

Conclusions: Sustainable increases in total health expenditure as a percent of GDP take on a critical significance to adequate health financing. Equity in health financing has been insufficient in China, and spatial and temporal differences of China's health financing structure are significant. The region' governments should adjust policy based on typical regions to weaken the differences.

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中国卫生筹资的时空解读:中国政府在新医改中 "做什么"?
目的:卫生支出及其结构分析在国家卫生政策研究中具有重要意义,国家卫生事业的公益性可以通过政府对卫生事业的投入体现出来。本研究旨在分析医疗卫生总费用、卫生筹资结构和政府卫生投入,为我国卫生政策调整提供参考:方法:使用 R 语言对中国 31 个地区 1990-2020 年间的医疗卫生总费用和卫生筹资结构进行描述和聚类分析,以了解中国医疗卫生总费用和卫生筹资结构的时空变化。利用描述和丰度热图对政府卫生投入进行分析,以了解政府卫生投入的时空变化:结果:2020 年人均卫生总费用达到 5112.3 元,卫生总费用占 GDP 的比重为 7.10%。1993-2006 年,政府卫生支出占卫生总费用的比重明显偏低(17.09% [16.30,17.88]),而在过去几年中,政府卫生支出占卫生总费用的比重已接近 30%(29.56% [28.73,30.3])。在全国 31 个地区中,西藏的政府卫生支出占卫生总费用的比例达到 67.94%,其他地区则维持在 27.866%(25.629-30.103)的水平。北京和上海近五年人均社会卫生支出占卫生总费用的比例均超过 50.00%,明显高于其他地区。2011-2019 年,西藏人均政府支出占 GDP 的比重最高(6.842%),江苏最低(仅 0.937%):可持续地提高卫生总费用占 GDP 的比例对于充足的卫生筹资具有至关重要的意义。中国卫生筹资的公平性不足,卫生筹资结构的时空差异显著。各地政府应根据典型地区调整政策,缩小差异。
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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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