李银鹤--中国青年卫生经济学者，毕业于挪威奥斯陆大学医学院，卫生经济管理与政策专业。长期从事医药行业科技政策、行业发展、企业兼并、分子公司管控模式等领域研究，曾发表《医疗机构整合创新多案例研究》、《全球CRO行业分布研究》、《医药集团分子公司管控模式研究》、《A projection of China’s health expenditures from today to 2050》等研究文献。

主要中文文献：

1、《医疗机构整合创新模式多案例研究》

简介：鉴于当前医疗机构整合创新研究的严重不足，以及我国医疗机构对整合创新理论的迫切需求，该研究针对医疗卫生领域不断涌现的整合创新现象，采用扎根理论的多案例研究方法，通过对六个典型整合创新案例的深入剖析，提出了我国三种典型的整合创新模式：知识整合型创新模式，经营整合型创新模式，以及资产整合型创新模式；并对三种整合模式的创新驱动力、创新路径和创新绩效等特征进行了深入研究，分析和总结了不同整合创新模式的共同和差异特征。本研究在整合创新路径方面的新认识和研究成果，将对我国医疗机构未来的整合创新提供直接的实践指导和必要的理论支撑。

2、《全球CRO行业分布研究》

简介：借助Google地图定位系统，通过对全球前40家大型CRO公司（占全球市场份额的80%-90%）分支机构的全球地理定位，分析发现了“美国东海岸”、“欧洲西部”、“亚洲东部”等3条CRO行业聚集带。同时，根据对3条聚集带上美国、英国、新加坡等典型案例国家CRO聚集区的深入研究，发现CRO行业的聚集与“人才资源”和“交通资源”等2大要素显著相关。其中，“人才资源”的主要标志性指标为“研究型大学”、“研究机构”；“交通资源”的主要标志性指标为“机场”、“高速公路”。该研究成果为我国CRO行业的布局规划、制定相关产业促进政策，具有现实的参考价值。

主要英文文献：

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

简介：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.