本文選題：新醫(yī)改 + 醫(yī)療衛(wèi)生��； 參考：《云南財經(jīng)大學》2017年碩士論文

【摘要】：我國的經(jīng)濟建設(shè)取得了舉世矚目的成就,各領(lǐng)域的改革開放繼續(xù)深化。在醫(yī)療衛(wèi)生領(lǐng)域,國務(wù)院于2009年提出深化醫(yī)藥衛(wèi)生體制改革的決定,基本醫(yī)療衛(wèi)生的可及性和醫(yī)療服務(wù)水平不斷提高,醫(yī)療保障制度不斷完善,醫(yī)療衛(wèi)生支出規(guī)模也越來越大,政府在醫(yī)療衛(wèi)生事業(yè)發(fā)展中的引導作用愈發(fā)明顯。為進一步推動醫(yī)療衛(wèi)生事業(yè)發(fā)展,各地不斷增加對醫(yī)療衛(wèi)生領(lǐng)域的投入,以云南省為例,在財政支出占GDP的比重不斷下降的情況下,醫(yī)療衛(wèi)生費用的支出在不斷增長,充分推動云南醫(yī)療衛(wèi)生事業(yè)發(fā)展的同時極大地減輕了全省城鄉(xiāng)居民的醫(yī)療負擔。但是醫(yī)療衛(wèi)生領(lǐng)域從資源的配置效率到管理制度都依然存在諸多問題,為提高醫(yī)療資源配置效率、體現(xiàn)醫(yī)療衛(wèi)生公共服務(wù)的公平性,充分滿足城鄉(xiāng)居民醫(yī)療衛(wèi)生服務(wù)需求,本文云南省醫(yī)療衛(wèi)生改革進行績效評價研究。基于云南省及各市2008-2015年的醫(yī)療衛(wèi)生數(shù)據(jù)樣本,效率績效選用數(shù)據(jù)包絡(luò)分析法(DEA)研究發(fā)現(xiàn)云南省各州市間的醫(yī)療衛(wèi)生財政支出效率差異較大,時間上的波動性也較大;規(guī)�？冃Р捎靡蜃臃治龇ǚ治龇ńY(jié)果顯示云南省醫(yī)療衛(wèi)生財政支出在絕對規(guī)模上逐年增加,但是其占省財政支出和GDP比重是下降的;公平性績效運用泰爾指數(shù)法分析發(fā)現(xiàn)醫(yī)療衛(wèi)生資源配置的公平性比醫(yī)療衛(wèi)生財政支出的公平性好,同時醫(yī)療衛(wèi)生財政支出公平性呈現(xiàn)地域上的差異。在實證分析結(jié)果的基礎(chǔ)上,結(jié)合云南省實際情況,本文建議從以下三個方面提升云南省醫(yī)療衛(wèi)生支出績效:1.提升規(guī)模績效:界定政府在醫(yī)療衛(wèi)生領(lǐng)域職責,加大財政資金的支持力度;合理規(guī)劃醫(yī)療衛(wèi)生的支出名目,保證資金的充足性;科學構(gòu)建醫(yī)療衛(wèi)生財政支出結(jié)構(gòu),提升財政支出規(guī)模效率;2.提升效率績效:完善財稅機制,提高醫(yī)療衛(wèi)生財政支出使用力;重視績效考核,加大政府對醫(yī)療衛(wèi)生財政支出的關(guān)注度;完善信息化建設(shè),提升醫(yī)療衛(wèi)生組織的服務(wù)效率;增強監(jiān)管力度,強化鄰域醫(yī)療衛(wèi)生的立體考核;3.提升公平性績效:以立體考核為基礎(chǔ)完善財政轉(zhuǎn)移支付制度,平衡醫(yī)療衛(wèi)生財政支出區(qū)域差距;擴大醫(yī)療衛(wèi)生人才隊伍,縮小醫(yī)療衛(wèi)生軟資源的地區(qū)差異;完善基層醫(yī)療衛(wèi)生基礎(chǔ)設(shè)施建設(shè),擴大醫(yī)療衛(wèi)生的承載力;強化基層醫(yī)療衛(wèi)生均等化意識,開放民眾利益訴求渠道。
[Abstract]:China's economic construction has made remarkable achievements, the reform and opening up in various fields continue to deepen. In the field of medical and health care, the State Council put forward a decision in 2009 to deepen the reform of the medical and health system. The accessibility of basic medical care and the level of medical services have been continuously improved, the medical security system has been continuously improved, and the scale of medical and health expenditure has become larger and larger. The guiding role of the government in the development of medical and health care is becoming more and more obvious. In order to further promote the development of medical and health services, various localities have continuously increased their investment in the field of medical and health care. Taking Yunnan Province as an example, the expenditure on medical and health expenses is increasing continuously while the proportion of financial expenditure in GDP is declining. While fully promoting the development of medical and health services in Yunnan Province, the medical burden of urban and rural residents in the province has been greatly alleviated at the same time. However, there are still many problems in the field of health care from the efficiency of resource allocation to the management system. In order to improve the efficiency of medical resources allocation, reflect the fairness of medical and health public services, and fully meet the needs of urban and rural residents for medical and health services. This paper studies the performance evaluation of medical and health reform in Yunnan Province. Based on the sample of medical and health data from 2008 to 2015 in Yunnan Province and other cities, the data Envelopment Analysis method (DEAA) is used to study the efficiency performance. It is found that there are great differences in the efficiency of medical and health financial expenditure among different cities in Yunnan Province, and the fluctuation in time is also great. The results of scale performance analysis showed that the medical and health financial expenditure of Yunnan Province increased year by year in absolute scale, but its proportion in provincial financial expenditure and GDP decreased. The fairness performance is analyzed by Tyr index method. It is found that the fairness of the allocation of medical and health resources is better than the fairness of the medical and health financial expenditure, and the fairness of the medical and health financial expenditure is different in different regions. On the basis of the results of empirical analysis, combined with the actual situation in Yunnan Province, this paper proposes to improve the performance of health expenditure in Yunnan Province from the following three aspects: 1. Enhance scale performance: define the responsibility of the government in the field of medical and health care, increase the support of financial funds; rationally plan the medical and health expenditure items to ensure the adequacy of funds; construct the structure of medical and health financial expenditure scientifically, Improving the efficiency of fiscal expenditure. Improve the efficiency performance: improve the fiscal and taxation mechanism, improve the ability to use medical and health financial expenditure; pay attention to performance appraisal, increase the government's attention to the medical and health financial expenditure; perfect the information construction, improve the service efficiency of the medical and health organization; Strengthen the supervision, strengthen the neighborhood medical and health stereoscopic assessment. Improve fairness performance: improve the financial transfer payment system based on three-dimensional assessment, balance the regional gap of medical and health financial expenditure, expand the medical and health personnel team, reduce the regional differences of medical and health soft resources; We should improve the construction of basic medical and health infrastructure, expand the carrying capacity of medical and health care, strengthen the awareness of equalization of medical and health care at the grass-roots level, and open up channels for the interests of the people.
【學位授予單位】：云南財經(jīng)大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R197.1;F812.45

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