医保基金支出的主动性和被动性影响因素分析——以大连市医保基金为例  

Active and Passive Factors Analysis of the Medical Insurance Fund Expenditure——Taking Dalian as an Example

作　　者：曲刚[1,2] 崔盛楠 唐加福[4] 

机构地区：[1]东北大学工商管理学院,辽宁沈阳110819 [2]大连大学附属新华医院,辽宁大连116021 [3]东北大学信息科学与工程学院,辽宁沈阳110819 [4]东北财经大学管理科学与工程学院,辽宁大连116021

出　　处：《工业工程与管理》2014年第2期120-125,共6页Industrial Engineering and Management

基　　金：国家自然科学基金资助项目(71021061)

摘　　要：我国医疗保险的基本原则是"以收定支,略有盈余",医保基金是医疗保障体系最直接、最关键的因素,医疗保险基金支出增加带来的基金相对不足,给可持续的医疗保障带来巨大压力。如何合理地控制医保基金使用,确保医疗保障体系能够持续、健康的发展,逐渐成为医疗保险相关研究的重要课题。基于大连市的医保基金数据,分析了医保基金支出的被动性和主动性影响因素,重点分析了起付线标准和医保指标的调整对医保基金支出的影响,为医保政策的调整提供数据支持和政策建议。The basic principle of our country＇s health care is ＂Revenue determines expenditure,with a little surplus left＂. Medical insurance fund is the direct key to the medical security system,the spending increases may cause a relatively shortage and put pressures on the sustainable health care development. Thus, the subject of medical insurance research now have been focused on the fair use of health insurance fund, and how to ensure the healthy sustainable development of medical insurance system. This paper is based on the data of Dalian medical insurance fund,analyzes the initiative and passive influence factors as well as the influence of the standard of starting paid level and medical insurance standard adjustment on medical insurance fund expenditure, which provides data supports and policy suggestions for the adjustment of medical insurance policy.

关 键 词：医保基金 医保指标 影响因素分析 统计分析 

分 类 号：R197.31[医药卫生—卫生事业管理] F840.684[医药卫生—公共卫生与预防医学]