《中国的医疗卫生事业》白皮书
White Paper: Medical and Health Services in China
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| 国务院新闻办公室于2012年12月26日（星期三）发表《中国的医疗卫生事业》白皮书，并于当日下午3时在国务院新闻办新闻发布厅举行新闻发布会，请卫生部党组书记、副部长张茅介绍《中国的医疗卫生事业》白皮书有关情况，并答记者问。 |
| 一、卫生基本状况 | I. Basic Conditions |
| 居民健康状况不断改善。从反映国民健康状况的重要指标看，中国居民的健康水平已处于发展中国家前列。2010年人均期望寿命达到74.8岁，其中男性72.4岁，女性77.4岁。孕产妇死亡率从2002年的51.3/10万下降到2011年的26.1/10万。婴儿死亡率及5岁以下儿童死亡率持续下降，婴儿死亡率从2002年的29.2‰下降到2011年的12.1‰，5岁以下儿童死亡率从2002年的34.9‰下降到2011年的15.6‰，提前实现联合国千年发展目标。 | The people's health has been improved. Judging from important indicators that give expression to national health, the health of the Chinese people is now among the top in developing countries. In 2010, the life expectancy was 74.8 years - 72.4 years for males and 77.4 years for females; the maternal mortality rate went down from 51.3 per 100,000 in 2002 to 26.1 per 100,000 in 2011; the infant mortality rate and the mortality rate of children under the age of five have kept dropping, with the former going down from 29.2 per thousand in 2002 to 12.1 per thousand in 2011, and the latter, from 34.9 per thousand to 15.6 per thousand, attaining ahead of schedule the UN Millennium Development Goal in this regard. |
| 建立起覆盖城乡的医疗卫生体系。一是公共卫生服务体系。包括疾病预防控制、健康教育、妇幼保健、精神卫生、卫生应急、采供血、卫生监督和计划生育等专业公共卫生服务网络，以及以基层医疗卫生服务网络为基础、承担公共卫生服务功能的医疗卫生服务体系。二是医疗服务体系。在农村建立起以县级医院为龙头、乡镇卫生院和村卫生室为基础的农村三级医疗卫生服务网络，在城市建立起各级各类医院与社区卫生服务机构分工协作的新型城市医疗卫生服务体系。三是医疗保障体系。这个体系以基本医疗保障为主体、其他多种形式补充医疗保险和商业健康保险为补充。基本医疗保障体系包括城镇职工基本医疗保险、城镇居民基本医疗保险、新型农村合作医疗和城乡医疗救助，分别覆盖城镇就业人口、城镇非就业人口、农村人口和城乡困难人群。四是药品供应保障体系。包括药品的生产、流通、价格管理、采购、配送、使用。近期重点是建立国家基本药物制度。 | Medical and healthcare systems covering both urban and rural residents have been put in place. Of these systems, the first is the public health service system, which covers disease prevention and control, health education, maternity and child care, mental health, health emergency response, blood collection and supply, health supervision, family planning and some other specialized public health services, and a medical and healthcare system based on community-level healthcare networks that provides public health services. The second is the medical care system. In the rural areas, it refers to a three-level medical service network that comprises the county hospital, the township hospitals and village clinics, with the county hospital performing the leading role, and township hospitals and village clinics service at the base. And in the cities and towns, it refers to a new type of urban medical health service system that features division of responsibilities as well as cooperation among various types of hospitals at all levels and community healthcare centers. The third is the medical security system. This system comprises mainly the basic medical security, supported by many forms of supplementary medical insurance and commercial health insurance. The basic medical security system covers basic medical insurance for working urban residents, basic medical insurance for non-working urban residents, a new type of rural cooperative medical care and urban-rural medical aid, which cover, respectively, the employed urban population, unemployed urban population, rural population and people suffering from economic difficulties. And the fourth is the pharmaceutical supply system, which covers the production, circulation, price control, procurement, dispatching and use of pharmaceuticals. The recent work is focused on establishing a national system for basic drugs. |
| 卫生筹资结构不断优化。卫生筹资来源包括政府一般税收、社会医疗保险、商业健康保险和居民自费等多种渠道。2011年，中国卫生总费用达24345.91亿元人民币，同期人均卫生总费用为1806.95元人民币，卫生总费用占国内生产总值的比重为5.1％。按可比价格计算，1978—2011年，中国卫生总费用年平均增长速度为11.32％。个人现金卫生支出由2002年的57.7％下降到2011年的34.8％，卫生筹资系统的风险保护水平和再分配作用不断提高。2011年，医院、门诊机构费用为18089.4亿元人民币，公共卫生机构费用为2040.67亿元人民币，分别占卫生总费用的71.74％和8.09％。医院费用中，城市医院、县医院、社区卫生服务中心、乡镇卫生院费用分别占64.13％、21.28％、5.17％、9.3％。 | The health financing structure has been constantly improved. China's health expenditure comes from the government's general tax revenue, social medical insurance, commercial health insurance, residents' out-of-pocket spending, etc. In 2011, the total health expenditure in China reached 2,434.591 billion yuan, 1,806.95 yuan per capita. The total expenditure accounted for 5.1% of the country's GDP. In comparable prices, the health expenditure grew by an average annual rate of 11.32% from 1978 to 2011. Individual "out-of-pocket" spending declined from 57.7% in 2002 to 34.8% in 2011, showing that health financing is working better in the areas of risk protection and re-distribution. In 2011, the spending on hospitals and outpatient establishments was 1,808.94 billion yuan, and that on public health agencies, 204.067 billion yuan, comprising 71.74% and 8.09%, respectively, of the total health expenditure. Of the total spending on hospitals, those on urban hospitals, county hospitals, community health service centers and township health service centers stood at 64.13%, 21.28%, 5.17% and 9.3%, respectively. |
| 卫生资源持续发展。截至2011年底，全国医疗卫生机构达95.4万个(所)，与2003年比较，医疗卫生机构增加14.8万个(所)。执业(助理)医师246.6万人，每千人口执业(助理)医师数由2002年的1.5人增加到1.8人。注册护士224.4万人，每千人口注册护士数由2002年的1人增加到1.7人。医疗卫生机构床位数516万张，每千人口医疗卫生机构床位数由2002年的2.5张提高到3.8张。 | Health resources have been developing in a sustained way. By the end of 2011, medical and healthcare institutions around the country totaled 954,000, an increase of 148,000 over 2003. Licensed doctors (assistants) reached 2,466,000, or 1.8 per thousand people, as compared with 1.5 per thousand people in 2002. Registered nurses totaled 2,244,000, or 1.7 per thousand people, as compared with one per thousand people in 2002. The number of hospital beds reached 5160,000, or 3.8 per thousand people, as compared with 2.5 per thou-sand people in 2002. |
| 医疗卫生服务利用状况显著改善。2011年，全国医疗机构诊疗人次由2002年的21.5亿人次增加到62.7亿人次，住院人数由2002年的5991万人增加到1.5亿人。中国居民到医疗卫生机构年均就诊4.6次，每百居民住院11.3人，医院病床使用率为88.5％，医院出院者平均住院日为10.3天。居民看病就医更加方便，可及性显著提高。15分钟内可到达医疗机构住户比例，由2003年的80.7％提高到2011年的83.3％，其中农村地区为80.8％。医疗质量管理和控制体系不断完善。建立无偿献血制度，血液安全得到保障。 | Marked improvement has been seen in the utilization of medical and health services. In 2011, medical institutions throughout the country hosted 6.27 billion outpatients, as compared with 2.15 billion in 2002; and admitted 150 million inpatients, as compared with 59.91 million in 2002. That year, Chinese residents went to the medical institutions for medical treatment 4.6 times on average; 11.3 of every 100 people were hospitalized; the utilization rate of hospital beds reached 88.5%; and the hospital stay of the inpatients averaged 10.3 days. These figures show that it has become increasingly convenient to see a doctor and more easily accessible to get medical services. In 2011, 83.3% of all households (80.8% in rural areas) could reach medical institutions within 15 minutes, as compared with 80.7% in 2002. Medical service quality management and control systems have been constantly improved. A system of blood donation without compensation has been established, so as to ensure blood supply and safety. |
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