中国卫生服务筹资:公平与发展——基于儿童发展的视角

政府卫生支出和新型农村合作医疗制度对妇女儿童卫生服务利用和健康结果有着重要的影响。较低的政府卫生支出水平和不充足的均等化转移支付,共同导致了地区和城乡之间儿童卫生服务利用的差距较大。妇幼保健和儿童卫生支出的个人付费,导致贫困儿童和流动儿童难以获得卫生服务。因此,建议加大对贫困县的转移支付以缩小差距,提高儿童卫生服务的政府支出份额,将儿童卫生服务纳入新型农村合作医疗制度,提高政府卫生支出的使用效果和效率,以及减轻贫困人口的卫生支出负担。

Financing Health Services in China: Equity and Development——Based on Veiwpoint of Children Development

This paper analyzes the government expenditure on health and the new rural cooperative medical system (RCMS), and their impact on maternal and child health services and their health conditions. It is shown that large gap among different regions and between rural and urban areas are there in the use of child health services. This unbalance is found to be caused by the relatively low level of government health expenditure and inadequate equalization of transfer payments. The "out-of-pocket" part of maternal and child health expenditure denies children of poor or immigrant families any access to health services. It is suggested that transfer payments be increased in the poverty-stricken areas to narrow the gap. The government expenditure on child health services should be increased,so that the RCMS may cover children of poor or immigrant families. The government expenditure on maternal and child health services should be spent in more effective and efficient way, so that the burden of health expenditure on the poor can be reduced.