College of Humanities and Social Sciences, China Medical University, Shenyang, China.
Administration School, Hainan Medical University, Haikou, China.
J Glob Health. 2020 Jun;10(1):010802. doi: 10.7189/jogh.10.010802.
In the past two decades, chronic non-communicable diseases have become the leading disease burden, and cardio-cerebrovascular diseases (CCVD) are the main causes of death in chronic diseases. It has become the focus of global public health attention, in this study, System of Health Accounts 2011 (SHA 2011) is used to calculate health expenditure, discuss its economic burden, and put forward countermeasures.
Data were collected by multi-stage stratified random sampling and the medical expenses of patients with CCVD were calculated based on SHA 2011, from the dimensions of the financing plan, institutional flow, and service function. Correlation and regression analysis were conducted by controlling factors influencing hospitalization expenses. All analysis were conducted by software SPSS.
The current health expenditure (CHE) of CCVD in Dalian was 3.986 billion Yuan, accounting for 12.88% of the CHE (30.947 billion Yuan). The current curative expenditure (CCE) of CCVD was 2.947 billion Yuan. 40.39% of CCVD financing came from social medical insurance, and the proportion of family health financing was higher (39.06%). The expenditures were consumed by general hospitals and elderly patients.
The expenditure burden of CCVD in Dalian was massive, and wasted the health resource severely. It is necessary for the government to adjust the financing structure, reallocate the expenses of CCVD, and make institutional flow and functional distribution more reasonable.
在过去的二十年中，慢性非传染性疾病已成为主要疾病负担，心脑血管疾病（CCVD）是慢性病死亡的主要原因。它已成为全球公共卫生关注的焦点，本研究采用 2011 年版《卫生核算体系》（SHA 2011）计算卫生支出，探讨其经济负担，并提出对策。
采用多阶段分层随机抽样方法收集数据，根据 SHA 2011 计算 CCVD 患者的医疗费用，从筹资计划、机构流向和服务功能三个维度进行分析。通过控制影响住院费用的因素，进行相关性和回归分析。所有分析均使用 SPSS 软件进行。
大连市目前 CCVD 的卫生支出（CHE）为 39.86 亿元，占 CHE（309.47 亿元）的 12.88%。目前 CCVD 的治疗支出（CCE）为 29.47 亿元。40.39%的 CCVD 筹资来自社会医疗保险，家庭健康筹资比例较高（39.06%）。支出消耗在综合医院和老年患者身上。
大连市 CCVD 的支出负担巨大，严重浪费了卫生资源。政府有必要调整筹资结构，重新分配 CCVD 的支出，使机构流向和功能分配更加合理。
