我国卫生总费用推算研究:基于SHA体系和人工神经网络方法

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目的:根据部分OECD国家卫生总费用的数据,推算我国卫生总费用占国内生产总值的水平。方法:选取遵循"卫生账户测算体系(SHA)的部分OECD国家为研究样本,根据文献确定影响卫生总费用的各类社会经济、人口卫生等因素,采用人工神经网络方法训练卫生总费用与影响因素之间关系的数量模型。在此基础上推算我国卫生总费用占GDP的比例。结果:人工神经网络分析得到1995~2003年我国卫生总费用占GDP的比例分别为:5.10%、5.20%、5.30%、5.41%、5.47%、5.49%、5.53%、5.94%和6.11%。模型推算结果与其他有关工作组的卫生总费用统计测算结果趋势一致,但费用水平稍高于后者。模型推算结果也与WHO对我国卫生总费用水平的估算结果相近。结论:国内对于我国卫生总费用的统计测算距离SHA的要求有差距,可能存在统计口径偏窄,测算水平偏低的问题。建议尽快根据SHA的方法测算我国卫生总费用,以增强测算结果的国际可比性。同时,提出了对改善我国卫生系统绩效的政策建议。 OBJECTIVE: To estimate the total health expenditure in China as a percentage of GDP according to the data of some OECD countries’ total health expenditure. Methods: Select some OECD countries that follow the Health Accounts Measurement System (SHA) as the study sample, and according to the literature to determine the various factors affecting the total cost of health, population health and other factors, the use of artificial neural network method to train the total health costs and impact The quantity of the relationship between the factors of the model.On this basis, we can calculate the proportion of total health expenditure as a percentage of GDP.Results: The total health expenditure in China from 1995 to 2003 was 5.10% and 5.20% respectively, 5.30%, 5.41%, 5.47%, 5.49%, 5.53%, 5.94% and 6.11% respectively. The results of the model estimation are in line with the statistical results of the total health expenditure of other relevant working groups, but the cost level is slightly higher than the latter. The results are also similar to the WHO estimates of the total cost of health in China.Conclusion: There is a gap between the national statistical estimates of the total cost of health in China and SHA, and there may be some problems such as narrow statistical coverage and low estimation level. SHA method to measure the total cost of health in China, in order to enhance the international comparability of measurement results.At the same time, put forward to improve the performance of China’s health system policy Suggest.
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