卫生政策"三难权衡"问题解决方案研究
Study on the Solution to the"Trilemma"of Health Policy
任晓明 1吴群红2
作者信息
- 1. 中国药学会 北京 102401
- 2. 哈尔滨医科大学卫生管理学院 哈尔滨 150076
- 折叠
摘要
目的:探讨卫生政策"三难权衡"问题是否有解,以揭示卫生政策及政策组合是否能够兼顾国民的"健康"、"富有"和"公平".方法:构建包含健康人力资本的动态随机一般均衡模型和卫生指标估算程序,采用贝叶斯模型比较方法,确定合理的模型设置;采用数值模拟方法,通过调整相应的参数,分别模拟单独实施医疗综合监管政策和单独实施医疗质量管理政策的效果,以及两项政策组合实施的政策效果.结果:单独实施医疗综合监管政策有可能造成健康结果对健康可负担性和筹资公平性的背离,单独实施医疗质量管理政策有可能造成健康可负担性和筹资公平性对健康结果的背离,而两项政策组合实施则能有效解决卫生政策"三难权衡"问题.结论:卫生政策"三难权衡"问题并非是无解的,"健康"、"富有"和"公平"的相互背离可以通过合理的政策组合设计得到调和.
Abstract
Objective:To explore whether there is a solution to the trilemma of health policy,and to reveal whether the health policy and policy portfolio can simultaneously improve the"health","wealth"and"equity"of residents.Methods:The study constructs a dynamic stochastic general equilibrium model and indicator estimation procedure that includes human health capital,and used Bayesian model comparison method to determine reasonable model settings.Using numerical simulation methods,by adjusting the corresponding parameters,it also simulates the policy effect of implementing comprehensive medical supervision policy and medical quality management policy separately,as well as the policy effects of combining these two policies.Results:Simply implementing comprehensive medical supervision policy may lead to the deviation of health outcomes from health affordability and financing equity,and simply implementing medical quality management policy may lead to the deviation of health affordability from health outcomes and financing fairness,and the combination of these two policies can effectively solve the trilemma of health policy.Conclusion:The problem of health policy trilemma is not unsolvable,and the mutual deviation of"health","wealth"and"equity"can be reconciled through reasonable policy combination design.
关键词
卫生政策/三难权衡/动态随机一般均衡模型Key words
health policy/trilemma/dynamic stochastic general equilibrium model引用本文复制引用
基金项目
国家社科基金重点项目(19AZD013)
国家药监局委托项目(1200000003)
出版年
2024
NETL
NSTL
万方数据