浙江省全民基本医疗保险筹资均等化发展及预测研究  

Study on Equalization Development and Prediction for the Financing of Universal Basic Medical Insurance in Zhejiang

作　　者：钱宇[1] 王小合[1] 张萌[1] 黄仙红[1] 顾亚明 王克春[3] 张亮[4] 

机构地区：[1]杭州师范大学医学院卫生事业管理系,杭州310036 [2]浙江省卫生和计划生育委员会,杭州310006 [3]浙江科技学院经济管理学院,杭州310023 [4]华中科技大学医药卫生管理学院,武汉430030

出　　处：《中国卫生经济》2016年第3期49-53,共5页Chinese Health Economics

基　　金：国家自然科学基金(71273080);浙江省社科规划课题(12JCSH05YB);浙江省医药卫生科技计划项目(2011KYA125)

摘　　要：目的:定量评价浙江省城乡全民基本医疗保险筹资均等化程度及发展趋势。方法:釆集2008—2012年浙江省6个不同经济类型市(县)所在统筹地区城乡全民基本医保险资水平等数据资料,运用差异系数、平均系数、泰尔指数和基尼系数综合测评其均等化程度及趋势。结果:近5年来,浙江全民基本医疗保险人均筹资水平均等化程度不断提高,其总泰尔指数由0.150下降到0.105,总基尼系数由0.435下降到0.381;2012年全民基本医疗保险的人均筹资水平和人均缴费占人均收入比例均未达到均等化底线标准,基本医保间人均筹资水平差异对总体差异的贡献率为75.238%;按照一定科学预设条件,预测到2020年该省全民基本医疗保险人均筹资水平可达到底线均等状态。结论:目前全民基本医疗保险在人均筹资水平上尽管存在较大差距,但其均等化发展态势强劲。建议该省应加强对省直管县财政体制,以及现行省级公共财政转移支付制度对全民基本医疗保险筹资均等化的促进效应实证分析,为进一步优化调整均等化的筹资结构及水平提供定量依据。Objective：To conduct quantitative evaluation on the equalization degree and the development trend of urban-rural ba.sic medical insurance financing in Zhejiang.Methods：The 2008—2012 financing level data of rural and urban basic medical insur.ance in 6 different typed pooling regions in Zhejiang were collected to comprehensively evaluate the equalization degree and trends based on uniformity coefficient,Theil index and Gini coefficient.Results：In last 5 years,the equalization level of financing per capi.ta under basic medical system showed increasing trend.Its total Theil index fell from 0.150 to 0.105,while the total Gini coefficient dropped from 0.435 to 0.381.None of per capita funding level and per capita pay cost of income proportion of basic medical insur.ance system were equal to the bottom line.The difference of per capita financing level between basic medical insurance systems con.tributed 75.238% to the overall difference.According to certain preconditions of science,it predicted that the province universal ba.sic health care per capita funding level would be equal to the bottom line by 2020.Conclusion：Although there was a big gap among3 basic medical insurance systems,but its equalization momentum was strong.It suggested to strengthen the province-controlled county financial system,conduct empirical analysis on the stimulation effects of the current provincial public fiscal transferring pay.ment system on the equalization of universal basic medical insurance financing,so as to provide qualitative evidence for optimizing and adjusting the financing structure and level.

关 键 词：基本医疗保险 筹资 均等化 预测 省直管县财政体制 浙江 

分 类 号：R197.1[医药卫生—卫生事业管理] F842.684[医药卫生—公共卫生与预防医学]