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目的:基于SHA 2011筹资维度框架核算上海市卫生费用,为政策制定者提供决策参考。方法:在SHA 2011分类原则下,从筹资方案、筹资方案收入和筹资机构三个维度进行核算。结果:2013年,上海市经常性卫生费用为1 083亿元,占GDP的比重是5.01%。经常性卫生费用中61.1%是公共筹资,但家庭现金卫生支出比例超过30%。卫生部门、人保部门分别管理14.3%和42.9%的资金。结论:上海市筹资体系由政府主导,部门间应建立联动机制以提高资金使用效率。OOP占比高,应靶向降低重点家庭现金卫生支出。鼓励非营利性机构和商业保险机构发展,建立多元化筹资体系。
OBJECTIVE: To calculate the cost of health in Shanghai based on the SHA 2011 financing dimensions framework and to provide policy makers with decision making references. Methods: Under the SHA 2011 classification principle, accounting is conducted from the three dimensions of financing plan, financing plan income and financing agency. Results: In 2013, the recurrent expenditure on health in Shanghai was 108.3 billion yuan, accounting for 5.01% of GDP. Of the recurrent costs of health, 61.1% are publicly funded, but household cash health expenditure exceeds 30%. The health department and the PICC manage 14.3% and 42.9% of the funds respectively. Conclusion: The Shanghai fund-raising system is led by the government and inter-departmental linkage mechanisms should be established to improve the efficiency of fund utilization. The high proportion of OOPs should target the reduction of cash expenditures for key families. Encourage the development of non-profit institutions and commercial insurance institutions and establish a diversified funding system.