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为科学量化政府对医疗机构应该投入多少、投向哪些方面、投入的效果如何等问题,利用卫生部2008年《全国卫生财务年报》数据,模拟测算出:当前我国社会经济发展阶段,政府应承担包括医疗机构人员经费、固定资产的折旧与维修、基本建设经费和专业设备购置费等在内的基本筹资职能为2480.9～2 880.6亿元,依据净收入与业务收入之间的关系,结合医疗机构现有运行效率,保障人员经费后,社会医疗费用负担可下降1589.6～3 203.0亿元(19.4%～39.1%);再保障基本建设和专业设备等经费后,医疗费用负担进一步下降2 379.6～4 794.9亿元(29.1%～58.6%)。提示,科学把握住净投入与毛收入之间关系的精髓,扭转浪费型费用补偿机制可现实解决百姓看病贵等主要问题,进而实现医改突破。
In order to scientifically quantify how much the government should invest in medical institutions, what aspects to invest in, what the effect of inputs and so on, we use the data from the “National Health Financial Annual Report” of the Ministry of Health in 2008 to simulate the current stage of social and economic development in our country. The basic fund-raising function of funds for medical institutions, depreciation and maintenance of fixed assets, capital construction and purchase of specialized equipment was 2480.9 ~ 288.06 billion yuan. Based on the relationship between net income and business income, After the operation efficiency and the protection of personnel expenses, the burden of social medical expenses can be reduced by 1589.6 to 323.17 billion yuan (19.4% to 39.1%); the burden on medical expenses further decreases after re-guaranteeing capital construction and specialized equipment, etc. 2 379.6 ~ 4 794.9 100 million yuan (29.1% ~ 58.6%). It is suggested that the scientific grasp of the essence of the relationship between net input and gross income and reverse the waste-based cost compensation mechanism can solve the major problems such as the expensive medical treatment for the public and thus achieve breakthroughs in medical reform.