| Objective:To understand the financing situation of total expenditure on health in Guizhou Province and change trend from 2019 to 2025.To understand the main influencing factors of total expenditure on health in Guizhou Province,and to provide scientific basis for formulating and adjusting relevant health policies.Methods:This study analyzed the financing level and financing structure of TEH in Guizhou Province based on the source method from 2011 to 2018.Based on the institutional method,the flow direction of TEH institutions in Guizhou Province from2015 to 2018 was analyzed.Based on the SHA 2011 framework accounting,this paper analyzed the changes of recurrent health expenses in Guizhou Province from2016 to 2018 from the perspectives of financing sources,institutions and functional composition.A matrix analysis was conducted on the recurrent health expenses in Guizhou Province from 2016 to 2018 from financing scheme,service provider,service function.The GM(1,1)model in the grey system theory was used to predict the TEH of Guizhou Province from 2019 to 2025,and the influencing factors of TEH in Guizhou Province were analyzed by the grey correlation analysis.Results:From 2011 to 2018,source-based TEH,per capita source-based TEH,and source-based TEH/GDP increased from 42.353 billion yuan,1220.91 yuan,and 7.40% to 120.676 billion yuan,3352.11 yuan,and 8.15%,respectively.From 2015 to2018,57.92% to 65.32% of TEH expenses went to hospitals,and the proportion of public health institutions decreased from 13.50% in 2015 to 6.27% in 2018.46.51%~51.62% of hospital expenses went to urban hospitals,37.51%~45.53% went to county hospitals,and 2.85%~13.08% went to community health service centers and township health centers.From 2016 to 2018,the per capita recurrent health expenditure in Guizhou Province was 2064.12~2362.59 yuan,and the proportion of recurrent health expenditure in GDP was 5.74%~6.31%.Among the sources of recurrent health expenditure in Guizhou Province,the proportion of public financing plans increased from 50.33% in 2016 to 61.35% in 2018,and household health expenditure decreased from 46.13% to 32.46%.From the perspective of institutional configuration,the proportions that flowed to hospitals,primary medical and health institutions,and preventive institutions were 65.69%~69.72%,3.21%~15.90%,and1.50%~4.83%,respectively.From the perspective of function flow,the expenses for treatment services and preventive services were 74.24%~83.16% and 5.07%~6.45%respectively.In 2025,TEH will reach 357.642 billion yuan,2.96 times that of 2018.From 2019 to 2025,TEH/GDP will increase from 8.25% to 9.97%.Government spending on health and private spending on health will decrease from 38.74%,22.58% to 25.90% and 16.83%,respectively,and social spending on health will increase from 38.69% to 57.27%.The top five grey correlation degrees of TEH influencing factors in Guizhou Province are per capita GDP,the number of hospital patients,the number of health technicians per thousand population,the number of hospital patients and the number of beds per thousand population,which are 0.90465,0.88486,0.85656,0.85183 and 0.80967,respectively.The last three grey correlation degrees of the proportion of population aged 65 and above,the total population at the end of the year and the proportion of government health expenditure in fiscal expenditure were 0.64221,0.62393 and 0.61654,respectively.Conclusions:The source method,institution method and function method can reflect the financing situation of TEH in Guizhou Province from different angles and levels,and can comprehensively analyze and evaluate TEH in multi-dimensional and comprehensive way.The TEH and recurrent health expenses in Guizhou Province showed a sustained and rapid growth trend,but there was still a large gap between the per capita level and the national average level.The equity of health financing in Guizhou Province has been improved,but the health financing structure still needs to be further optimized.The medical resources and treatment services in Guizhou Province showed an "inverted triangle" structure in the composition of different levels of medical institutions.The problems of "attaching importance to medical treatment and neglecting prevention" and "taking medical care and prevention" still exist in Guizhou Province.From 2019 to 2025,TEH in Guizhou Province will continue to maintain a rapid growth trend,and the equity of health financing will be further improved.Per capita GDP is the most important influencing factor of TEH in Guizhou Province.The number of hospital patients and the number of health technicians per thousand population followed by health indicators;Population factors have little influence on TEH in Guizhou Province. |
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