如何化解人口老龄化的卫生支出压力?OACHSSCD

This study approaches the issue from the perspective of health resource allocation models,to systematically examine the moderating effects of different institutional arrangements on the relationship between population aging and health expenditures,which can answer the question of how to alleviate the health expenditure pressures of population aging.Based on panel data from OECD countries from 2000 to 2022,cluster analysis is used to determine the health resource allocation models of each country,and a moderating effect model is constructed and empirically tested to examine the differentiated effects of different allocation models.The findings reveal that health resource allocation in OECD countries exhibits five typical models:public financing—nursing-oriented,public financing—basic healthcare equilibrium,joint financing—medicine-focused and nursing-neglected,self-funded—nursing-supported,and self-funded—facility-intensive.The health resource allocation model is a key variable in moderating the economic impact of population aging,and it produces different moderating effects,including cost amplification,cost neutralization,and cost savings.Furthermore,the moderating effects of certain health resource allocation models become dynamic as the degree of aging increases.The study suggests that a health resource allocation model with excessive marketization and regulatory absence may significantly amplify the health expenditure cost pressure of aging,while a model that introduces a reasonable co-payment mechanism and prudently plans long-term care investment shows stronger cost control capability.Therefore,the key to building a healthcare service system lies in achieving an aging-friendly resource allocation model,which involves adopting more direct subsidies to the demand side in financing mechanisms,restructuring the integrated service system around communities in resource allocation.