本文選題：公共衛(wèi)生　切入點：財政投入　出處：《南京大學(xué)》2014年碩士論文

【摘要】：人類對衛(wèi)生產(chǎn)品與服務(wù)的需求是對健康需求的派生,我國人口老齡化程度的不斷加劇、生活環(huán)境質(zhì)量的下降、人均預(yù)期壽命的延長以及人們生活水平的普遍提升都將不可避免地導(dǎo)致人們對衛(wèi)生服務(wù)需求的增加。如今,衛(wèi)生費用的增速已遠超同期GDP以及人均收入的增速,高額的醫(yī)藥費用不僅讓因病致貧、因病返貧現(xiàn)象在農(nóng)村更加突出,也使城市居民不堪重負。而公共衛(wèi)生囊括了和人們生活息息相關(guān)的基本公共衛(wèi)生和基本醫(yī)療服務(wù),是一國提高全民身體素質(zhì)和社會衛(wèi)生水平的關(guān)鍵環(huán)節(jié)。由于公共衛(wèi)生產(chǎn)品的公共物品屬性、公共財政的內(nèi)在要求、國家投資人力資本以及維護社會安定和政治合法性的需要等,政府必須積極干預(yù)公共衛(wèi)生體系的建立健全。 政府如何支持公共衛(wèi)生事業(yè)的發(fā)展,其核心是公共財政在多大程度上合理引導(dǎo)了公共衛(wèi)生的發(fā)展。研究公共衛(wèi)生領(lǐng)域的財政保障政策可以為政府更合理地介入公共衛(wèi)生領(lǐng)域提供理論依據(jù)和實踐指導(dǎo),能夠明晰我國公共衛(wèi)生財政保障政策的特點及影響,認清當(dāng)前衛(wèi)生財政投入現(xiàn)狀,進而幫助學(xué)者和政府部門解析當(dāng)下相關(guān)政策的實施效率與不足之處,以形成切實可行的改進方案,增強政府衛(wèi)生支出分配的合理性,在資源有限的前提下提高資金利用效率,進而提高城鄉(xiāng)居民衛(wèi)生水平,促使政府更好地提供充分適當(dāng)?shù)墓残l(wèi)生產(chǎn)品,為經(jīng)濟發(fā)展和社會進步提供健康的人力資源。 本文綜合運用國內(nèi)外文獻研究、比較分析以及泰爾指數(shù)等方法,明確了公共衛(wèi)生的概念,重點探討公共衛(wèi)生領(lǐng)域財政保障政策的公平性,不僅就我國財政對公共衛(wèi)生的投入總量進行了橫向、縱向?qū)Ρ确治?也從政府、社會、個人三方承擔(dān)比例、各級政府承擔(dān)比例、預(yù)防保健費用和醫(yī)療費用比例、城鄉(xiāng)衛(wèi)生支出差距、地區(qū)間衛(wèi)生支出差距等方面,詳細論證了現(xiàn)行財政政策在公共衛(wèi)生投入結(jié)構(gòu)上的現(xiàn)狀。在談到地區(qū)間政府預(yù)算衛(wèi)生支出差距時,以全國和江蘇省2012年醫(yī)療衛(wèi)生投入為例,運用泰爾指數(shù)進行定量分析,表明這種地區(qū)性衛(wèi)生支出不均衡現(xiàn)象不單單只存在全國范圍內(nèi),也存在于省級區(qū)域內(nèi)。通過以上實證分析,本文發(fā)現(xiàn),我國在公共衛(wèi)生領(lǐng)域的財政支出是遠遠不夠的,投入結(jié)構(gòu)不盡合理,表現(xiàn)在：中央和地方政府對公共衛(wèi)生的投入分擔(dān)機制不合理,對治療性的基本醫(yī)療服務(wù)和預(yù)防性的基本公共衛(wèi)生服務(wù)投入不均衡,財政投入城鄉(xiāng)分布嚴重失衡,財政投入在全國范圍內(nèi)及省內(nèi)地區(qū)間差異均較明顯。本文最終從政府職能的行使、城鄉(xiāng)二元社會經(jīng)濟結(jié)構(gòu)、財政制度及相關(guān)法律政策等方面闡述了財政投入現(xiàn)狀的深層原因,并針對研究中發(fā)現(xiàn)的問題,提出相應(yīng)的促進公共衛(wèi)生財政投入均衡化、合理化的原則和政策建議。
[Abstract]:Human demand for health products and services is derived from the demand for health. The aging of the population in China is increasing, and the quality of living environment is declining.The increase in life expectancy and the general improvement in living standards will inevitably lead to an increase in the demand for health services.Today, the growth of health costs has far outpaced the growth of GDP and per capita income in the same period. The high medical costs not only cause poverty due to illness, but also make the phenomenon of returning to poverty more prominent in rural areas, and also overburdened urban residents.Public health includes basic public health and basic medical services, which are closely related to people's lives. It is a key link for a country to improve the physical quality of the whole people and the level of social health.Due to the attribute of public goods of public health products, the inherent requirement of public finance, the need of national investment in human capital and the need to maintain social stability and political legitimacy, the government must actively intervene in the establishment and perfection of public health system.The core of how the government supports the development of public health is the extent to which public finance reasonably guides the development of public health.The research on the financial security policy in the field of public health can provide theoretical basis and practical guidance for the government to intervene in the field of public health more reasonably, and can clarify the characteristics and influence of the financial security policy of public health in China.Recognizing the current health financial investment situation, and then helping scholars and government departments to analyze the current implementation efficiency and deficiencies of relevant policies, in order to form a feasible improvement plan, and enhance the rationality of the distribution of government health expenditure.Under the premise of limited resources, we can improve the efficiency of capital utilization, improve the health level of urban and rural residents, promote the government to provide adequate and appropriate public health products, and provide healthy human resources for economic development and social progress.In this paper, the concept of public health is clarified by means of domestic and foreign literature research, comparative analysis and Tyr index, and the equity of public health policy in the field of financial security is discussed.Not only has the total financial input to public health in our country been analyzed horizontally and vertically, but also from the government, society, and individuals, the government at all levels has borne the proportion, the cost of preventive health care and the proportion of medical expenses.The difference of urban and rural health expenditure and the gap of regional health expenditure are discussed in detail, and the present situation of public health investment structure of current fiscal policy is demonstrated in detail.When talking about the gap between regional government budget and health expenditure, taking the medical and health investment in the whole country and Jiangsu Province as an example, using the Terre index to carry out quantitative analysis, it shows that this phenomenon of regional health expenditure imbalance exists not only in the whole country, but also in the whole country.It also exists in provincial areas.Through the above empirical analysis, this paper finds that the fiscal expenditure in the field of public health in China is far from enough, and the structure of the input is unreasonable, which is manifested in: the sharing mechanism of the central and local governments' input to public health is unreasonable.The investment in basic medical services and preventive basic public health services is not balanced, the distribution of financial investment in urban and rural areas is seriously out of balance, and the difference of financial investment is obvious in the whole country and between provinces and regions.Finally, this paper expounds the deep reasons of the present situation of financial investment from the aspects of the exercise of government functions, the dual socio-economic structure of urban and rural areas, the financial system and related laws and policies, and aims at the problems found in the study.This paper puts forward the corresponding principles and policy suggestions to promote the equalization and rationalization of public health financial investment.
【學(xué)位授予單位】：南京大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：F812.45;R197.1

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