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本文运用宏观卫生经济核算的方法，按照卫生总费用分配流向，整理测算了1978－1993年中国农村贫困地区卫生总费用时间序列的数据并对测算结果进行了政策分析。测算结果发现，贫困的农村地区卫生发展迟缓，与全国平均水平比较，差距在明显扩大；贫困地区在人均国内生产总值水平只有全国平均水平的30％的情况下，投了4．6％的国内生产总值发展卫生保健服务。即使如此，贫困地区居民医疗消费的实际支付能力与当地医疗机构的收费额度相比较，差距日益扩大。在现有支付能力下，贫困农民根本不可能从医疗机构得到基本的卫生保健服务。一方面，是贫困农民医疗需求不足；另一方面，贫困地区医疗机构供给相对有余，效率低下人浮于事。在我国贫困地区卫生费用对农民人均纯收入的多少竟然缺乏弹性，说明贫困地区温饱问题尚未解决。因此，很难指望贫困农民在温饱与健康的选择中，放弃温饱而选择健康。作者认为，农村居民基本卫生服务的实现程度，农村居民大病住院医疗的保障程度，是农村贫困地区卫生行政的主要责任。
This article uses macroeconomic health accounting methods, according to the distribution of the total flow of health expenditure, collate and measure the data of the total health expenditure time series in China’s rural poverty-stricken areas from 1978 to 1993, and carries out policy analysis of the calculation results. The calculation results show that poor health development in rural areas is slow, and the gap is significantly widened compared with the national average; poverty-stricken areas have invested 4.6% in the country when the per capita GDP level is only 30% of the national average. Gross domestic product develops health care services. Even so, the actual payment capacity of medical expenses for residents in impoverished areas is compared with that of local medical institutions, and the gap is widening. With the existing payment capacity, it is impossible for poor farmers to obtain basic health care services from medical institutions. On the one hand, it is the poor medical needs of poor farmers; on the other hand, medical institutions in the poor areas have relatively more supplies and less efficient people. In China’s poverty-stricken areas, health expenditure on the per capita net income of farmers actually lacks flexibility, indicating that the issue of food and clothing in the poverty-stricken areas has not yet been resolved. Therefore, it is difficult to expect poor farmers to give up their food and choose health in their choice of food and clothing. The author believes that the degree of realization of basic health services for rural residents and the degree of protection for major inpatient medical care for rural residents are the primary responsibility for health administration in rural poor areas.