社会医疗保险基金收支平衡与风险评估研究  

Study on the Balance of Social Medical Insurance Fund and Risk Assessment

作　　者：马桂峰[1,2] 盛红旗 张婷[1] 韩健 马安宁[4] 王培承[1,2] 郑文贵[1,2] 杨蕾[1] 安洪庆[1] 

机构地区：[1]潍坊医学院,山东潍坊261053 [2]"健康山东"重大社会风险预测与治理协同创新中心,山东潍坊261041 [3]潍坊市人力资源与社会保障局,山东潍坊261041 [4]济宁医学院,山东济宁272000

出　　处：《中国卫生经济》2017年第7期25-27,共3页Chinese Health Economics

基　　金：国家自然科学基金项目(71273191;71673202);山东省自然科学基金项目(ZR2014GL012;ZR2016HL45);山东省教育厅人文社科项目(J15WB02;J15WB43);"健康山东"重大社会风险预测与治理协同创新中心重点资助项目(XT1401001;XT1401002;XT1401003)

摘　　要：目的:分析我国社会医疗保险基金收支平衡变化情况,评估基金超支风险发生的时点和程度。方法:根据社会医疗保险基金自1995年到2015年21年间收入、支出和年度结余情况,利用时间序列模型预测到2030年的收支、结余情况。结果:社会医疗保险基金收入与支出呈逐年递增趋势。基金支出与基金收入比值从1995年的75.35%上升到1998年的87.96%,随后逐渐下降到2001年的63.63%。其后又逐渐上升,2015年到达83.19%。预测到2021年基金收入总额为20 075.10亿元,支出为20 256.40亿元,年度基金支出大于年度基金收入。结论:在我国老龄化趋势不断加剧的背景下,医疗费用快速上涨,社会医疗保险基金的收支平衡压力越来越大,预测到2021年基金将出现收不抵支的超支风险。Objective： To analyze the changes of the balance of payments in China＇s social medical insurance fund, and evaluate the time and extent of the risk of the occurrence of the risk. Methods： According to the income, expenditure and annual balance of the social medical insurance fund from 1995 to 2015, the time series model was used to fnrecast the balance of income and expendi- ture till the year of 2030. Results： The ratio of expenditure and incnme of social medical insurance funds increased from 75.35% in 1995 to about 87.96% in 1998, decreased to 63.63% in the year of 2001, and then gradually increased, reaching tn the level of 83.19% in 2015. According to the forecast, the total fund revenue in 2021 would be 2 007 510 million yuan, the expense would be 2 025 640 million yuan, the annual fund expenditure would be larger than the annual fund income. Conclusion： With the background of increasing ageing trend in China, the medical expense increased rapidly, the revenue halance pressure of insurance fund increased by years. It would have the risk of fund income over expenditure overruns in 2021 according to the forecast.

关 键 词：风险评估 医疗保险基金 时间序列 预测 

分 类 号：F842.684[经济管理—保险] R197.1[医药卫生—卫生事业管理]