河北省医疗卫生财政支出绩效分析.pdfVIP

摘 要 公共医疗卫生作为保障居民身体健康、促进社会和谐稳定的基础性工程，是我国近 年来改善民生过程中面临的重要任务。自2009 年我国提出并推行医疗卫生体制改革政 策以来，河北省高度重视公共医疗卫生发展，不断增加医疗卫生财政资金的投入规模。 如何以有限的医疗卫生财政资金创造更多的医疗卫生资源，完善城乡基层医疗卫生体系， 提高公共医疗卫生水平是河北省需要解决的现实问题。 本文以委托代理理论、公共产品理论和新公共管理理论为基础，对财政医疗卫生支 出内容和医疗卫生财政支出绩效的概念进行界定，着重对河北省医疗卫生财政支出的现 状进行分析，并从效率和公平两个方面进行实证研究，采用 DEA 和主成分分析法研究 了河北省2008 年至2016 年的支出效率和各地市2010 年至2016 年的支出效率及影响因 素，结果表明河北省公共医疗卫生财政支出规模效益递减，多个城市综合技术效率偏低。 同时，采用泰尔指数分析法研究了河北省区域内、区域间在医疗卫生财政支出、医疗卫 生机构、机构床位和卫生技术人员资源配置上的差异情况，结果表明河北省公共医疗卫 生支出、机构床位和卫生技术人员资源差异受地区间差异影响较大，这些情况综合导致 河北省医疗卫生财政支出绩效水平不高。本文在坚持公平与效率相协调、支出责任与财 力相一致的原则下，从提高河北省医疗卫生财政支出效率和促进河北省医疗卫生公平程 度的角度出发，对改善河北省财政转移支付行为和优化省属各市医疗卫生财政支出结构、 建立健全监督机制提出对策建议。 关键词 河北省 医疗卫生 财政支出 绩效 I Abstract Public medical and health service, as a basic project to protect the health of residents and promote social harmony and stability, is an important task facing China in the process of improving peoples livelihood in recent years. Since China proposed and implemented the medical and health system reform policy in 2009, Hebei province has attached great importance to the development of public health care and has continuously increased the scale of investment in medical and health finance. How to create more medical and health resources with limited medical and health financial funds, improve the urban and rural primary health care system, and improve the public health level is a realistic problem that Hebei province needs to solve. Based on principal-agent theory, public product theory and new public management theory, this paper defines the concept of financial health expenditure and medical expenditure, and focuses on the analyses for current situation of medical expenditure in Hebei province and carr