密 级： 学校代码：10075 分类号： 学 号：20090087 经济学硕士学位论文 河北省公共卫生服务城乡统筹发展研究 学 位 申 请 人：裴朝阳 指 导 教 师：成新轩 教授 学 位 类 别：经济学硕士 学 科 专 业：财政学 授 予 单 位：河北大学 答 辩 日 期：二一二年五月 Classified Index: CODE: 10075 U.D.C: NO: 20090087 A Dissertation for the Degree of M. Economics Study on the Overall-planning of the Urban-Rural Public Health Services in Hebei Province Candidate： Pei Zhaoyang Supervisor： Prof. Cheng Xinxuan Academic Degree Applied for： Master of Economics Specialty： Public Finance University： Hebei University Date of Oral Examination： May，2012 摘 要 I 摘 要 随着经济的发展和社会的进步， 整个社会对公共卫生服务的需求呈现出全面快速的 增长趋势。近年来，河北省的经济保持了较好的发展势态，人们的物质需求得到保障的 同时，公共卫生服务等公共产品的需求却不断增加，尤其是农村地区居民对公共卫生服 务的需求。然而，农村地区的公共卫生服务供给严重不足，农村居民对公共卫生服务需 求与公共卫生服务供给的之间的矛盾日益严重，导致了区域、城乡地区的公共卫生发展 不均衡，城乡公共卫生服务水平差距不断拉大。在这种情况下，全面统筹河北省城乡公 共卫生服务，推进城乡公共卫生服务均等发展，维护社会居民整体的健康水平，有着十 分重要的现实意义。 本文主要以城乡二元经济和公共产品理论为指导， 在分析公共卫生服务相关概念的 基础上，通过设置一系列的基本公共卫生服务均等化评价指标，对河北省城乡公共卫生 服务的现状进行深入分析。根据上述河北省公共卫生服务指标，分析总结财政体制、卫 生体制及社会结构三方面所存在的问题， 分析制约河北省城乡公共卫生服务统筹发展的 因素，并在这一基础上，通过对财政体制的改革创新、卫生资金的统筹供给以及相关配 套制度的建立，实现两政府、两地区、两部门、两手段的有效结合，建立信息共享平台 以及预警机制，抓住建设“民生财政”的新契机，有针对性的提出了河北省统筹城乡卫 生服务发展的对策建议。 关键词 公共卫生服务 有效供给 公共财政 城乡统筹 Abstract II Abstract With the development of the economics and the progress of the society, the demand of the whole community for the pubic health services presents a comprehensive and rapid growth trend. In recent years, Hebei Provinces economy has maintained a good momentum,at this time the development of peoples material needs are better protected, however，the demand of the public health services and other public goods are increasing rapidly, especially the demand for health services in the rural areas. However, the supply of the pubic health services in rural areas is a serious shortage, the contradictory between the rural residents for public health services demand and the supply of the public health services are increasingly serious, resulting in the highly unequal between the urban and rural areas of health development ,and the widening gap between urban and rural public health service level .In this case, overall coordination of the urban and rural public health services in Hebei Province, promoting urban and rural health services more equal development, and safe guarding the health of whole society residents, has a very important practical significance. Guiding by the urban-rural dual economic and public goods theory，this paper，on the basis of analysis of the concept of public health services,sets a series of equalization of basic public health services evaluation, in-depth analysis the current situation of the urban and rural public health services in Hebei Province .Summed up the problems of three aspects of the financial system, health system and social structure, derived factor restricting the co-ordinating the development of Hebei Province, urban and rural public health services, and on this basis, for the estabishment of the financial system reform and innovation, health funds supply and supporting, targeted suggestions of urban and rural public health service development in Hebei Province. Keywords: Public Health Service Effective Provision Public Finance Planning the Urban-Rural 目 录 III 目 录 第 1 章 绪论.1 1.1 研究背景及意义.1 1.1.1 研究背景.1 1.1.2 研究意义.2 1.2 国内外研究综述.4 1.2.1 国内研究综述.4 1.2.2 国外研究综述.6 1.3 研究的主要内容和方法.7 1.3.1 研究的主要内容.7 1.3.2 研究的主要方法.7 1.4 论文的主要创新点.8 第 2 章 统筹城乡公共卫生服务发展的理论基础.9 2.1 刘易斯的二元经济结构理论.9 2.2 公共产品理论.10 2.2.1 政府提供公共产品的必要性.