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目的:从时间和空间角度分析新医改以来我国卫生筹资结构状况。方法:分析我国卫生筹资结构的纵向变化情况,同时运用Arc Gis 10.0软件对31个省份的卫生筹资结构数据进行空间自相关分析。结果:各省份卫生事业投入适度增长,筹资结构得到优化,但地区差异依旧明显,投入结构还不尽合理;2011—2013年政府卫生支出和2013年社会卫生支出占卫生总费用的比重存在空间集聚特征;局部自相关分析显示,个人和社会卫生支出比重“热点”区域集中于东部,政府卫生支出比重“热点”区域集中于中西部。结论:在保证卫生投入总量的基础上深入优化卫生筹资结构,提高政府卫生投入,降低个人现金负担;关注卫生筹资结构的地域差异性和聚集性,各地区需要结合卫生事业发展大局和本地特点,探寻符合本地实际的卫生筹资结构,优化筹资方式。
Objective: To analyze the health financing structure in China since the new medical reform from the perspective of time and space. Methods: To analyze the longitudinal changes of the health financing structure in China. At the same time, the spatial autocorrelation analysis of health financing structure data in 31 provinces was carried out by ArcGIS software. Results: The health care investment in all provinces increased moderately and the financing structure was optimized. However, the regional differences were still obvious and the input structure was still not reasonable. The spatial distribution of government health expenditure and social health expenditure in the total health expenditure in 2011-2013 Local autocorrelation analysis showed that the proportion of personal and social health expenditure was concentrated in the east and the area of government health expenditure was concentrated in the central and western regions. Conclusions: On the basis of ensuring the total amount of health investment, we should further optimize the health financing structure, increase government health investment and reduce the personal cash burden. Focusing on the regional differences and aggregation of the health financing structure, all regions need to combine the overall development of health care and local characteristics , Explore the local health financing structure and optimize the financing method.