Researce About The Responsibity Of Hierarchical Health Finanding And Fund Flow Of Guangxi Province

Background: In 2009,"Opinions of the Central Committee and the Communist Party of China on deepening the reform of medical and health system" a circular emphasized clearly that it is necessary to establish and improve the government health input mechanism.It is also necessary to establish a government-led diversified health input mechanism and make sure the leading position in the process of providing public health and basic medical services.Under the background of current supply-side policy reform,under the text of the inevitable requirement of building a comprehensive well-off society,promoting the health of entire citizens and realizing healthy China,along with the healthy Guangxi goal,it is of high importance to adhere to the "three to one supplement" policy and improve the quality and efficiency of government health input.Objective: Its purpose is to promote healthy and sustainable development of health service institutions,improve health service conditions and health level of citizens,guarantee and enhance people's livelihood.Since new medical reformulation,this article assesses general condition of Guangxi governmenthealth input through analyzing specific financing rank responsibility,cash flow direction and general condition of Guangxi government health input.We carried out in-depth discussion and puts forward related suggestions from the perspective of supply policy reform aiming at the existing problems of government health input.Methods: We found out current problems and proposed corresponding suggestions for Guangxi government through the of literature combing.Taking the case of Guangxi government health investment as an example,the paper analyzed the scale and financing classification responsibility and capital flow of Guangxi government by comparative analysis and other quantitative research methods.Results: i)From the perspective of government health investment: Guangxi government health input show an increasingly upward trend,while it slows down after the new reform,from 11.615 billion yuan(2009)to 35.533 billion yuan(2014),with an annual growth of 25.06% which is higher than the national average level.From the point of relative size,the proportion of government health input of current fiscal spending increased from 7.16% in 2009 to 10.21%in 2014,the proportion of the total health expenses basically remain above 36%with some fluctuations.ii)Analysis based on hierarchical financing responsibility: the main source of Guangxi government health basic expenditure from provincial,city and county finance.provincial,municipal and county finance accounted for 4.21%,31.20% and 4.21% respectively in 2014,in which the county finance was the main part.Compared with 2009,the proportion of provincial finance aid relatively decreased,while the county finance went up.Project spending mainly comes from the central,provincial,municipal andcounty finance and they accounted for 51.70%,32.98%,2.48% and 12.85%respectively in 2014,in which the central government accounted for the main part.Also,the municipal financial input remain in stable and the central,provincial,county financial input increased,however,the central government and municipal finances share decreased slightly and provincial finance and county-level finances increase in proportion.iii)Analysis of the capital flow: the main inflow recipient of Guangxi financial health expenditure is township health center,which accounted for nearly 30%.Basic expenditure is mainly used for salary welfare spending and the focus of project spending shifts from the grassroots health institutions to public health.Conclusions: The government health input system construction is imperfect and the investment scale need to reach a sustainable growth.There are still certain irrational investment structure which means that the concept of "pay attention to investment but ignore performance" is in urgent need of transformation.Under the background of supply-side reform,We recommended that the government should ensure the supply of system,increase the effective supply,reduce the invalid one,complete the short supply as well as improving the quality and efficiency of supply Second,We suggested that government should improve the system of health investment and construction,establish a stable and sustainable health financing mechanism and adjust the supply structure of medical and health services.Third,health service development model should be innovated and performance-based evaluation and supervision system should be established to ensure the sustainable and reasonable development of Guangxi government health investment,realizing the effective utilizatin of government health input to promote the development of our country health.