李銀鶴

李銀鶴——中國青年衛生經濟學者,畢業於挪威奧斯陸大學醫學院,衛生經濟管理與政策專業。

研究方向

長期從事醫藥行業科技政策、行業發展、企業兼併、分子公司管控模式等領域研究,曾發表《醫療機構整合創新多案例研究》 《全球CRO行業分布研究》 《醫藥集團分子公司管控模式研究》《A projection of China’s health expenditures from today to 2050》 等研究文獻。

中文文獻

1、《醫療機構整合創新模式多案例研究》

簡介:鑒於當前醫療機構整合創新研究的嚴重不足,以及我國醫療機構對整合創新理論的迫切需求,該研究針對醫療衛生領域不斷湧現的整合創新現象,採用紮根理論的多案例研究方法,通過對六個典型整合創新案例的深入剖析,提出了我國三種典型的整合創新模式:知識整合型創新模式,經營整合型創新模式,以及資產整合型創新模式;並對三種整合模式的創新驅動力、創新路徑和創新績效等特徵進行了深入研究,分析和總結了不同整合創新模式的共同和差異特徵。本研究在整合創新路徑方面的新認識和研究成果,將對我國醫療機構未來的整合創新提供直接的實踐指導和必要的理論支撐。

2、《全球CRO行業分布研究》

簡介:藉助Google地圖定位系統,通過對全球前40家大型CRO公司(占全球市場份額的80%-90%)分支機構的全球地理定位,分析發現了“美國東海岸”、“歐洲西部”、“亞洲東部”等3條CRO行業聚集帶。同時,根據對3條聚集帶上美國、英國、新加坡等典型案例國家CRO聚集區的深入研究,發現CRO行業的聚集與“人才資源”和“交通資源”等2大要素顯著相關。其中,“人才資源”的主要標誌性指標為“研究型大學”、“研究機構”;“交通資源”的主要標誌性指標為“機場”、“高速公路”。該研究成果為我國CRO行業的布局規劃、制定相關產業促進政策,具有現實的參考價值。

英文文獻

《A projection of China’s health expenditures from today to 2050》

簡介:Currently China is experiencing the historic demographic transition as other developed and developing countries in our world. The average age of Population rapidly increased from 26.1 years old in 1980 to 32.9 years old in 2005 (United Nations, 2006). Furthermore, due to the inception of “One Child Policy” in 1979, Chinese society already lost 250 millions young individuals during the last decades (Mcloughlin, 2005, p. 310). Consequently, the population would become elderly more quickly than the natural transition.

Age has been widely considered as one of principal factors determining the nature and extent of an individual’s demand for health services. Some cross-sectional data already indicated that, with the increases of age the demand for healthcare services rises steeply; and the healthcare expenditures of older age groups are considerably higher than the remainder of the population (OECD, 1988, pp. 27-33).

Therefore, we can expect that with the dramatic increases of age population and relative shrinkages of working populations, the ageing issue would significantly challenge Chinese society’s capability to deal with the age wave in health care sector.

Unfortunately, “China is poorly prepared to care for a rapidly increasing elderly population, and the time to address the challenge is running dangerously short” (Jackson & Howe, 2004, p. 13). And few analysis and projections were conducted on the future healthcare-expenditures. Due to the lacuna of this field, the health authority may lack the scientific fundament to adopt suitable long-term health policies for population ageing. Therefore, the proper projections of future health expenditures from the perspective of population ageing are quite urgent and necessary.

In an attempt to fill the lacuna in this area, we quantitatively analyzed the mechanism of population ageing on China’s health expenditures, and projected the future trends of health spending caused by pure ageing effects in this study.

In order to address the potential impacts of the population ageing on health expenditures, the projection methodology adopted by the Canadian Institute for Health Information (CIHI 2005) and OECD (1988) was applied in this study. Namely, we regarded the total health expenditures in each particular year as the aggregate of the health expenditures consumed by each age group. The health expenditures in each age group for a particular year were estimated by multiplying per capita health spending in the age group and the number of persons in the age group.

Furthermore, for the projection of total health expenditures, the values of per capita health expenditures in each age-group and the populations in each age-group in each year are required. Fortunately, two internationally reputable institutions—Population Division of United Nations and American Census Bureau have presented quite comprehensive projections of China’s population to 2050. Thus, we basically concentrated on the addressing of per capita health expenditures in each age group.

Since China currently lacks the data of per capita health expenditure by age groups, we developed several simulation models of per capita health expenditures in each age group based on empirical evidences from China and other countries. And then the most preferred simulation-models were selected into the projecting of future health expenditures.

Through our studies on the population ageing and health expenditure, we discovered several meaningful findings which may enable us to better understand the mechanism of the ageing effects on health expenditures and the future trends of China’s health expenditures.

Firstly, we discovered that the trends of per capita health expenditures by age groups in studied developed countries were remarkably similar, although the data of per capita health expenditures was collected at various points of times from four different countries.

Secondly, according to several results of simulation models, we concluded that China’s incidences of chronic diseases can largely explain the historical out-of-pocket health expenditure during 1995-2005. Or in other words, we found new evidences which are able to justify the statement of World Bank that China’s “chronic diseases already account for the majority of hospital services and health care costs” (World Bank, 1992, p. 12) in the context of out-of-pocket health expenditures.

Finally, according to our estimates, the ageing effects will continually enhance its impacts on total health expenditures and come in full force during 2035s-2040s. Thereafter, such effects will be gradually moderated. As a whole, by 2050s the population ageing will solely drive the Total health expenditure rise almost twice as the total health expenditures in year 2005.

Meanwhile, since the population ageing will enforce its impacts on the Out-of-pocket health expenditures by a different mechanism compared with Total health expenditures, the ageing effects on the out-of-pocket health expenditures will appear earlier and more significantly.

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