内容提要:医疗卫生体系的最终目的是维护和促进人们的健康水平,因此对健康产出的影响是衡量医疗卫生体系效果的根本指标。筹资责任在公共和个人之间如何划分,是医疗卫生制度的基本特征之一。本文用中等以上收入国家1995-2007年的跨国面板数据,实证研究医疗卫生公共筹资对健康产出的影响。实证研究结果显示:医疗卫生筹资公共化程度越高,越有利于健康水平的改善。同时,政府主导的公共筹资制度的效果受到政府行为的影响。本文也发现,政府医疗卫生投入力度越大,越有利于健康水平的改善。但是政治分权与否并不是关键,地方政治领导利益与当地居民利益一致或地方公共投入的财权与事权匹配,会影响到健康产出。
关键词:医疗卫生公共筹资、医疗卫生私人筹资、政府激励、健康产出
The Impact of Public Healthcare Financing on Health Outcomes:Evidence from Cross-country Panel Data Chen Qiulin (Institute of Population and Labor Economics,Chinese Academy of Social Sciences) Abstract: The ultimate goal of healthcare system is to maintain and promote the health of the people,so the impacts on health outcomes are the fundamental measures to evaluate healthcare system.Financing mechanism,especially the division of financing responsibility between public and private,is the basic feature of a healthcare system.This article aims to study how public healthcare financing affects the health outcomes,using cross-country panel data of upper-high and high countries from 1995 to 2007.Empirical study verified the following hypothesis:Public financing is superior to private financing in improving health status in terms of population life expectancyMeanwhile,as a government-led healthcare financing mechanism,public healthcare financing system may be affected by government behaviors.This paper also found that,more government health expenditure produces better health outcomes.Political decentralization is not key to influence health outcomes,while the consistency of local political leaders'interests with local residents' interest,as well as the balance of financial power and duties on public good provision,can improve health outcomes.
Keywords:public healthcare financing, private healthcare financing, government incentive, health outcome
JEL Classifications:I12, I13, H51
全文阅读 陈秋霖,中国社会科学院人口与劳动经济研究所,电子邮箱:
chen_ql@cass.org.cn。
作者感谢北京大学国家发展研究院健康中国研究组组会和博士生论坛的讨论和建议,特别感谢李玲、李明强、胡赟之等对本文研究提供的帮助和宝贵意见。
文章出处:劳动经济研究,2014年第2卷第3期