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什么样的政府卫生投入方式有利于城乡健康公平

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本文基于Grossman健康需求理论,利用2007-2020年省级面板数据,研究了政府卫生投入的"补供方"和"补需方"方式以及二者组合,对城乡健康公平的影响,从而回答了何种卫生投入有利于城乡健康公平这一问题.结果表明:第一,总体上看,在研究期间,单一的投入方式无论是"补供方"还是"补需方"对城乡健康公平的作用都是负向的,两者需要一定条件相互协调才能有利于城乡健康公平;第二,具体来看,"补供方"降低了健康服务公平以及健康投入公平;"补需方"提高了健康状况公平,但是降低健康投入公平;第三,从二者的组合方式看,当"补供方"与"补需方"比例小于0.6586时,能显著提高城乡健康公平;第四,政府投入方式对城乡健康公平的影响程度受相关条件约束:当一个地区的年人均GDP较高时或者当医疗市场处于低供给、高需求时,"补供方"对城乡健康公平的不利影响减弱,"补需方"对城乡健康公平的不利影响增强.基于以上研究,提出了转换和优化政府卫生投入方式,促进城乡健康公平的政策建议.
What types of government health investment methods are beneficial to equity in urban and rural health?
Drawing on Grossman's health demand theory,this paper utilizes provincial panel data from 2007 to 2020 to study the impact of government health investment through both"supply-side supplementation"and"demand-side supplementation",as well as their combination,on urban-rural health equity.This addresses the question of what type of health investment promotes urban-rural health equity.The findings are as follows:First,overall,during the study period,either mode of investment alone,whether supply-side or demand-side,negatively affects urban-rural health equity,requiring a certain degree of coordination between the two to be beneficial.Second,specifically,supply-side supplementation reduces equity in health services and health investments,while demand-side supplementation improves health status equity but reduces health investment equity.Third,in terms of their combination,a ratio of supply-side to demand-side supplementation lower than 0.6586 significantly enhances urban-rural health equity.Fourth,the degree to which government investment methods affect urban-rural health equity is contingent on specific conditions:In regions with higher per capita GDP or where the healthcare market is characterized by low supply and high demand,the adverse impact of supply-side supplementation on urban-rural health equity diminishes,while the adverse impact of demand-side supplementation intensifies.Based on these findings,policy recommendations are proposed to transform and optimize government health investments to promote urban-rural health equity.

government health investmenturban-rural health equitysupply-side supplemen-tationdemand-side supplementation

罗能生、廖胤凯

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湖南大学经济与贸易学院,长沙 410006

政府卫生投入 城乡健康公平 补供方 补需方

2024

系统工程理论与实践
中国系统工程学会

系统工程理论与实践

CSTPCDCSSCI北大核心
影响因子:1.575
ISSN:1000-6788
年,卷(期):2024.44(10)