民族地区医养结合养老服务财政支出效果的影响路径分析——基于宁夏五市的问卷调查

健康中国战略下,各级财政逐步增加了对医养结合养老服务的财政投入,优化资金使用方式,可以实现医养结合养老服务的提质增效。基于一主多元的供给模式,提出医养结合养老服务财政支出效果影响路径的结构方程模型(SEM)和研究假设。结果表明:财政支出效果对政府更好地履行提供医养结合养老服务职责、提高老年人服务满意度、提升服务提供方能力、感知质量均具有正向促进作用。强化对需方的补贴力度,对政府职能、满意度、服务提供方和感知质量的影响最大,印证了财政应逐步由“补供方”为主向“补需方”为主转变。同时,通过购买服务、PPP模式等形式,发挥财政对供方补贴的杠杆作用,撬动市场资源,进而促进医养结合养老服务提质增效。

An Analysis of the Influencing Factors concerning the Effect of the Financial Expenditure of Medical and Old-age Care Services in Ethnic Minority Areas: A Questionnaire Survey of Five Cities in Ningxia

Guided by the strategy of healthy China,financial departments at all levels have gradually increased their financial investment in the integration of medical care and old-age care services,and optimized the fund use,which can achieve the improvement of quality and efficiency of the integration of medical care and old-age care services.This paper puts forward the structural equation model(SEM)and research hypothesis of the influencing factors of financial expenditure of medical care combined with old-age care based on the supply model of one principal and multiple factors.The results show that the fiscal expenditure has a positive effect on the government to better perform the responsibility of providing medical care combined with old-age care services,improve the service satisfaction of the elderly,improve the ability of service providers,and improve the perceived quality.Strengthening the subsidy to the demander has the greatest impact on the government's functions,satisfaction,service providers and perceived quality,which confirms that the finance should gradually change from“supplement supplier”to“supplement demander”.At the same time,we should play the leverage role of financial subsidies to suppliers,make a good use of market resources,and promote the integration of medical and old-age care services to improve the quality and efficiency through the purchase of services,the PPP model and other forms.