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目的测算我国基本药物的筹资水平,分析政府承担基本药物筹资责任的可行性,提出适宜的基本药物筹资模式。方法以《2014年中国卫生和计划生育统计年鉴》为主要数据来源,以相关政策中基本药物的配置标准为依据,按照两种筹资方案测算我国2013年基本药物的筹资水平。利用卫生经济学的相关理论,分析基本药物税收筹资和社会医疗保险筹资模式的优缺点及可行性,提出适合我国国情的基本药物筹资模式。结果根据两种筹资方案,我国2013年的基本药物筹资水平分别为3 790.43亿元和4 321.25亿元,分别占全国2013年财政收入的2.94%和3.35%。政府财政有能力负担基本药物的筹资责任,政府税收筹资模式优于社会医疗保险筹资模式。结论为了提高基本药物的公平性和可及性,政府应该并有能力承担基本药物的主要筹资责任,基本药物筹资可以优先选择税收筹资模式。
Objective To estimate the level of fund-raising of essential drugs in our country, analyze the feasibility of the government taking on the responsibility of fund-raising of essential drugs, and put forward the appropriate fund-raising mode of essential drugs. Methods Based on the “2014 China Statistical Yearbook on Health and Family Planning” as the main data source, based on the allocation standard of essential drugs in the relevant policies, the funding level of basic drugs in China in 2013 was estimated according to two financing plans. Utilizing the relevant theories of health economics, this paper analyzes the advantages and disadvantages of the basic drug tax collection and social medical insurance financing models and their feasibility, and puts forward the basic drug financing model that suits our national conditions. Results According to the two financing plans, the level of fund-raising of basic medicines in 2013 in our country were 3,790.43 billion yuan and 421.225 billion yuan respectively, accounting for 2.94% and 3.35% of the national total in 2013 respectively. Government finance has the ability to afford the fund-raising responsibility for essential medicines, and the government tax collection model is superior to the social health insurance financing model. Conclusion In order to improve the fairness and accessibility of essential medicines, the government should and can afford the major funding responsibility of essential medicines, and the priority of financing of essential medicines can be the mode of tax financing.