The Survey And Analysis On Health Inputs In Qingdao City From1996to2011

Health Funds refer to the budget subsidies for medical institutions of the health sectors founded by all levels of government, including the subsidies for all types of hospitals, sanatorium, urban community health service centers, township hospitals, the independent clinic belonging to the health sectors, the operating expenses for Disease Control and Prevention agencies, health surveillance agencies, maternity and children care institutions, cadres training institutions and other health operating institutions, the government grants for the new rural cooperative medicine and other various funds.The Chinese Health is supported by some welfare policies from government, health development must be coordinated with the national economic and social development and the grants of the people health must be adapted with the level of economic development. Governments are responsible for the advancement of public health and should strive to increase investment in health, mobilize all sectors of society to raise development funding of health services extensively, and citizens should also gradually increase their own medical health inputs. It is expressed clearly that the inputs from the central and local government must increase with the economic development year by year, and no less than the growth of the financial expenditure(The Decision of the CPC Central Committee and the State Council on Health Reform and Development,1997). The government health spending growth rate must be higher than the recurrent expenditure, which makes the proportion of government health spending accounted for recurrent expenditure increasing gradually (The views of deepening the reform of medical and health system of the CPC Central Committee and State Council,2009).Research and analysis on health Funds carried out in domestic provinces and cities showed that the average annual growth rate of health expenditure was far below the fiscal revenue and expenditure, or there was considerable gap between health inputs and actual need in most of the regions. With the development of Qingdao economic and improvement of people’s living standards, as well as industrialization, urbanization, population aging, disease spectrum changes, the masses’demanding to improve medical and health services have become increasingly, which challenged medical and health work seriously. Therefore, it is very important to analyze the status, trends and distribution structure of government health inputs and discuss the output and effectiveness of medical services to control cost growth, develop macroeconomic policy and make the regional health planning.Under the above background, this study was to acquire the impact of the economic development and fiscal expenditure of Qingdao on health inputs, analyze its allocation structure and the output and effectiveness of health services, which provided the basis for the government to develop a macro policy. The main purpose was to understand the status of Qingdao Municipal Health input growth, distribution and make effectiveness evaluation.In this study, with the time series data (1997～2011), trend analysis, regression analysis between health expenditure and GDP, fiscal spending and comparative analysis of the health expenditure of the allocation and trends in different organizations and regions were carried out. Trend analysis, structural analysis, comparative analysis of allocation of health resources, service capabilities and efficiency of health care institutions, hospital income and health care expenditure level of residents and a set of indicators on behalf of the residents’health level were finished at the same time.The date came from the existed literature, Qingdao Municipal Statistical Yearbook, Qingdao Health Bureau Statistical Yearbook, Statistical Communique of the Chinese health development, China Statistical Yearbook.Main results as follows:1. Qingdao health inputs were more effective, health expenditure grew faster than the financial expenditure, which improved the health service capacity and residents health significantly in recent years and were higher than the national average.2.Health input policies were instable, for example, the inputs were less effective during the10th Five-Year period and less attention were paid to health than the national average during the11th Five-Year period.3. The proportion of Hospital expenditure and ratio between urban and rural areas in the distribution constitution were reduced, but "more city and less rural, more treatment and less prevention" still exist. 4. Medical and health system reform were effective initially, which improved the fairness, accessibility and convenience for the patients, but medical treatment is still difficult and expensive.Policy recommendations as follows:1. Long-term effective mechanism of health investment should be established, which clears the responsibility for health spending from all levels of government and the ratio of health investment&GDP through legislation, assessment and accountability to ensure that "government health spending growth rate must be higher than the recurring financial expenditure and the proportion of government health spending accounted for recurrent financial expenditure must increased annually ".2. Health services targeted input distribution and use effects should be improved.*With equalization, identify key target population according to the principle of priority; improve government health input objective..Ensure government subsidies of basic health insurance and basic public health services funding per capita increase corresponding to the raising level of economics.*Modify the mechanism of government input in urban and rural primary health care institutions, change the status of too concentrated urban medicine and health resource inverted triangle allocation.*Increase the financial investment of the public health service agencies and construct the public health service system covering urban and rural residents.3. Accelerate the reform of the medical and health; improve the ability of medical services.*Standardize the diagnosis and treatment behavior by strengthening the quality of medical care management to improve the efficiency of hospital medical services.*Control health expenditure rises unreasonable by changing the payment method.*Increase some medical services price reflecting the technical service value of the medical staff; embody the deserved technical value and occupational risks of the medical staff, improve their activity and work efficiency.*Expand the scope of services of the basic-level health institutions to improve medical services.