Changes in health expenditures in China in 2000s: has the health system reform improved affordability.
Changes in health expenditures in China in 2000s: has the health system reform improved affordability.
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DOI：
10.1186/1475-9276-12-40
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发表时间：
2013-06-13
影响因子：
4.8
通讯作者：
Tang S
中科院分区：
文献类型：
--
作者：
Long Q;Xu L;Bekedam H;Tang S
中国于2000年代初启动的医疗卫生体制改革提高了医疗保险的覆盖面，显着提高了绝大多数中国人口的医疗保健使用率。本研究旨在考察2000-2011年中国卫生总支出结构的变化，并调查其人口，特别是城乡地区和不同社会经济发展区域之间的医疗卫生经济负担。卫生支出数据来自1990-2011年中国国民健康账户研究，用于计算医疗卫生财政负担的其他数据来自《中国统计年鉴》和《中国人口统计年鉴》。卫生总支出分为政府和社会支出和自付费用。医疗保健的经济负担以人均自付费用占家庭人均年度生活消费支出的百分比来估算。 2000年至2011年间，中国卫生总费用从319元人民币增至1888元人民币（51美元增至305美元），年均增长17.4%。政府和社会卫生支出快速增长，年均增速分别达到22.9%和18.8%。城市居民自付费用占卫生总费用的比重从2005年的53%下降到2011年的36%，但农村人口自付费用仅略有下降，从53%下降到50%。自付费用占家庭年度生活消费的比例持续上升，特别是在欠发达地区的农村人口中（2000年为6.1%，2011年为8.8%）。作为改革战略的一部分，中国用于补贴医疗保险的公共资金迅速增加，但这并没有减少过去十年医疗保健的自付费用。农村人口医疗卫生经济负担加重。有患病成员的农村家庭的负担能力越来越差，特别是在欠发达地区。需要采取有效的成本控制措施，包括医疗保健提供者支付改革和完善的医疗保险计划，为寻求基本医疗保健的弱势中国人提供更好的财务保护。
China's health system reform launched in early 2000s has achieved better coverage of health insurance and significantly increased the use of healthcare for vast majority of Chinese population. This study was to examine changes in the structure of total health expenditures in China in 2000–2011, and to investigate the financial burden of healthcare placed on its population, particularly between urban and rural areas and across different socio-economic development regions. Health expenditures data came from the China National Health Accounts study in 1990–2011, and other data used to calculate the financial burden of healthcare were from China Statistical Yearbook and China Population Statistical Yearbook. Total health expenditures were divided into government and social expenditure, and out-of-pocket payment. The financial burden of healthcare was estimated as out-of-pocket payment per capita as a percentage of annual household living consumption expenditure per capita. Between 2000 and 2011, total health expenditures in China increased from Chinese yuan 319 to 1888 (United States dollars 51 to 305), with average annual increase of 17.4%. Government and social health expenditure increased rapidly being 22.9% and 18.8% of average annual growth rate, respectively. The share of out-of-pocket payment in total health expenditure for the urban population declined from 53% in 2005 to 36% in 2011, but had only a slight decrease for the rural population from 53% to 50%. Out-of-pocket payment, as a percentage of annual household living consumption, has continued to rise, particularly in the rural population from the less developed region (6.1% in 2000 to 8.8% in 2011). The rapid increase of public funding to subsidize health insurance in China, as part of the reform strategy, did not mitigate the out-of-pocket payment for healthcare over the past decade. Financial burden of healthcare on the rural population increased. Affordability among the rural households with sick members, particularly in the less developed region, is getting worse. It needs effective measures on cost control including healthcare provider payment reform and well developed health insurance schemes to offer better financial protection for the vulnerable Chinese seeking essential healthcare.
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影响因子：
2.8
作者：
Yu B;Meng Q;Collins C;Tolhurst R;Tang S;Yan F;Bogg L;Liu X
通讯作者：
Liu X
影响因子：
4.5
作者：
Tang S;Tao J;Bekedam H
通讯作者：
Bekedam H
影响因子：
4.8
作者：
Liu X;Tang S;Yu B;Phuong NK;Yan F;Thien DD;Tolhurst R
通讯作者：
Tolhurst R
DOI：
10.1016/s0140-6736(08)61364-1
发表时间：
2008-10-25
期刊：
Lancet (London, England)
影响因子：
--
作者：
Tang S;Meng Q;Chen L;Bekedam H;Evans T;Whitehead M
通讯作者：
Whitehead M
DOI：
10.2471/blt.10.084087
发表时间：
2012-03-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Niëns, LM;Poel, E Van de;Brouwer, WBF
通讯作者：
Brouwer, WBF