新常态下山西省新医改财政投入绩效研究

发布时间：2018-07-04 12:28

本文选题：新常态 + 新医改　；参考：《首都经济贸易大学》2017年硕士论文

【摘要】：提高政府财政投入新医改绩效,是维护医疗卫生事业健康有效运行的关键。十八大提出要实现基本公共服务的均等化,十八届三中和四中全会又分别提出继续深化医疗卫生体制改革和推动医疗卫生工作的法治化。要解决居民“看病贵、看病难”难题,关键在于政府如何提高财政医疗卫生投入绩效。从2009年新医改推进以来,各级地方政府担负主要的财政保障职责,因此从省级政府角度研究新医改财政投入绩效,不仅在理论方面有其指导意义,更在于对进一步深化新医改也有实质性现实意义。本文首先梳理了新医改相关政策及其价值导向和实现目标,并从公共产品、市场失灵、政府干预等角度分析了政府主导医疗卫生投入的理论依据。文章接下来分析,不论是山西全省还是各地级市经济发展都由超高速迅速滑落为低速增长,甚至出现负增长,山西经济步入了调整经济发展方式的新常态。经济发展的放缓直接影响到公共财政收入的增长,而公共财政收入萎缩伴随的却是公共财政支出刚性增长的矛盾性困境。2015年山西省GDP增长为3.10%,公共财政收入增长为-9.77%和新医改财政投入增长为-19.09%,既是明显的印证。因此转变山西省新医改财政投入结构,由原先注重“量”的增长到注重“质”的改进,是山西省新医改财政投入绩效提高的关键所在。本文运用DEA方法对山西省新医改财政投入绩效作实证对比分析,推导出不论是从全省时间序列纵向分析,还是从省内地区间或省际间横向对比分析,影响山西省新医改财政投入综合效率的因素,主要是财政资源在医疗卫生领域配置效率低下,即纯技术效率是影响综合绩效的关键因素的结论。因此,提出了改进山西省新医改财政投入绩效的落脚点应为改善财政资源在医疗卫生领域的配置结构,并据此结论,论文从保障新医改财政投入适度增长、优化新医改财政投入配置效率以及提高新医改财政投入的生产效率三个方面提出优化建议。
[Abstract]:Improving the performance of the new medical reform is the key to maintain the healthy and effective operation of the medical and health care. The 18th National Congress proposed to realize the equalization of basic public services, and the third and fourth Plenary sessions of the 18th CPC Central Committee respectively proposed to continue to deepen the reform of the medical and health system and to promote the rule of law in medical and health work. In order to solve the problem of "expensive and difficult to see a doctor", the key lies in how the government improves the performance of financial health care investment. Since the promotion of the new medical reform in 2009, local governments at all levels have assumed the main financial support responsibilities. Therefore, it is not only of guiding significance in theory to study the financial investment performance of the new health care reform from the perspective of provincial governments, It is also of practical significance to further deepen the new health care reform. This paper first combs the new medical reform related policies and the value orientation and the realization goal, and analyzes the government leading medical and health investment theory basis from the public goods, the market failure, the government intervention and so on. The next analysis shows that the economic development of Shanxi Province or all prefectural cities has declined from super high speed to low speed and even negative growth. Shanxi economy has entered the new normal of adjusting the mode of economic development. The slowdown in economic development has a direct impact on the growth of public revenue. In 2015, the GDP growth of Shanxi Province was 3.10%, the public finance revenue growth was -9.77%, and the financial input of the new medical reform was -19.09%, which was the obvious proof. Therefore, the key to improve the financial investment performance of Shanxi new medical reform is to change the financial input structure of new medical reform in Shanxi province from the growth of "quantity" to the improvement of "quality". This paper uses DEA method to make empirical comparative analysis on the financial investment performance of Shanxi Province's new medical reform, and deduces the vertical analysis of the province's time series, as well as the horizontal comparative analysis between regions within and between provinces. The main factors affecting the comprehensive efficiency of financial input in Shanxi Province are the low efficiency of allocation of financial resources in the field of medical and health care, that is, the conclusion that pure technical efficiency is the key factor affecting the comprehensive performance. Therefore, the paper puts forward that the aim of improving the financial investment performance of new medical reform in Shanxi Province should be to improve the allocation structure of financial resources in the field of medical and health care, and based on the conclusion, the paper tries to ensure the moderate increase of financial investment in the new medical reform. To optimize the allocation efficiency of new medical reform financial input and to improve the production efficiency of new medical reform financial input, the paper puts forward three optimization suggestions.
【学位授予单位】：首都经济贸易大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1;F812.45

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