Department of Breast Surgery, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
College of the Humanities and Social Sciences, China Medical University, Shenyang, Liaoning Province, China.
J Glob Health. 2020 Jun;10(1):010803. doi: 10.7189/jogh.10.010803.
China's health financing system has changed from the government-led mode under the planned economy to the diversified mode under the market economy. Equity in health financing has been a national health priority. This study aimed to predict changes in total health expenditure (THE), government health expenditure (GHE), social health expenditure (SHE) and out-of-pocket health expenditure (OOP) in China from 2018 to 2022, and to provide a theoretical basis for health policy adjustment.
Based on health expenditure date of time series from 1978-2017, R3.5.1 software was used to construct the Autoregressive Integrated Moving Average (ARIMA) model.
The model of THE, GHE, SHE and OOP are ARIMA (3.3.0), ARIMA (1.3.1), ARIMA (2.4.0), ARIMA (2.2.2). According to the simulation results, in 2022, China's THE is expected to reach 8473.00 billion Yuan, and the constituent ratios in GHE, SHE and OOP will be 25.49%, 51.25% and 23.26%, respectively. The proportion of THE to GDP will continuously increase from 2018-2022 at a reasonable pace, while THE itself will increase rapidly.
China should take effective measures to control the excessive growth of THE, keep decreasing the OOP percentage, and improve the efficiency and fairness of the use of health funds.
中国的卫生筹资体系已从计划经济下的政府主导模式转变为市场经济下的多元化模式。卫生筹资公平性一直是国家卫生工作的重点。本研究旨在预测 2018-2022 年中国卫生总费用（THE）、政府卫生支出（GHE）、社会卫生支出（SHE）和个人卫生支出（OOP）的变化情况，为卫生政策调整提供理论依据。
基于 1978-2017 年卫生支出时间序列数据，使用 R3.5.1 软件构建自回归求和移动平均（ARIMA）模型。
THE、GHE、SHE 和 OOP 的模型分别为 ARIMA（3.3.0）、ARIMA（1.3.1）、ARIMA（2.4.0）、ARIMA（2.2.2）。根据模拟结果，2022 年中国 THE 预计将达到 84730.00 亿元，GHE、SHE 和 OOP 的构成比例分别为 25.49%、51.25%和 23.26%。THE 占 GDP 的比例将从 2018-2022 年以合理的速度持续增长，而 THE 本身将迅速增长。
中国应采取有效措施控制 THE 的过度增长，持续降低 OOP 比例，提高卫生资金使用效率和公平性。
