广西新型农村合作医疗保险运行效率评价  

Evaluation on operational efficiency of new rural cooperative medical insurance system in Guangxi

作　　者：何崇伟 罗小娟 韦征 黄高明[1] HE Chongwei;LUO Xiaojuan;WEI Zheng;HUANG Gaoming(Department of Biostatistics,Guangxi Medical University,Nanning 530021,China;Office of Guangxi Center for Disease Prevention and Control,Nanning 530021,China)

机构地区：[1]广西医科大学生物统计学教研室,南宁530021 [2]广西疾病预防控制中心办公室,南宁530021

出　　处：《右江医学》2019年第6期461-467,共7页Chinese Youjiang Medical Journal

基　　金：国家自然科学基金(81260450)

摘　　要：目的评估广西2010~2016年新型农村合作医疗保险运行效率。方法基于广西74个县(市)2010~2016年新型农村合作医疗保险面板数据,采用三阶段DEA模型和三阶段Malmquist模型从静、动态角度开展效率评价。结果2010~2016年新型农村合作医疗保险收支水平、补偿人次数、补偿额度以及实有医技人员数、实有床位数增长迅速,2016年参保率达到99.87%,人均筹资为573.38元,基金使用率最高为86.32%;地区经济发展和医疗服务水平对保险的运行效率影响显著,综合技术效率均值为0.894,纯技术有效率和有效占比总体呈增长趋势,全要素生产率累计下降28.8%,技术退步是下降的主要原因。结论广西新型农村合作医疗保险运行良好,疾病保障范围和患者受益程度显著提高,但制度效率下降明显,基金使用效率低于预期。下一步需注重提高管理水平,增加经济和医疗强县的卫生投入,建立一套科学准确的测算体系。ObjectiveTo estimate the operational efficiency of new rural cooperative medical system in Guangxi from 2010 to 2016. MethodsBased onthe data of the new rural cooperative medical insurance system of 74 counties(cities) in Guangxi from 2010 to 2016,three-stage DEA model and three-stage Malmquist model were adopted to evaluate the new rural cooperative medical insurance from both static and dynamic perspectives. ResultsFrom 2010 to 2016,income and expenditure levels,the number of compensators,the limit of compensation,the number of medical technicians and the number of beds in hospitals of the new rural cooperative medical insurance increased rapidly.In 2016,the rate of participating insurancereached 99.87%,per capita financing was 573.38 yuan,and the highest fund utilization rate was 86.32%.Regional economic development and medical service level have significant impacts on the operational efficiency of insurance,average comprehensive technical efficiency was 0.894,the total efficiency and effective proportion of pure technology showed an increasing trend,total factor productivity declined by 28.8%,and technological retrogression was the main reason for the decline. ConclusionThe new rural cooperative medical insurance system in Guangxi is in good condition,the range of the disease coverage and patient benefit improve significantly,butsystem efficiency drop obviously,and the use efficiency of insurance fund is lower than expected.It is necessary to improve medical insurance management level,increase health input in counties with developed economy and health care,and establish a set of scientific and accurate measurement system.

关 键 词：新型农村合作医疗保险 三阶段DEA模型 三阶段Malmquist模型 运行效率 

分 类 号：R197.1[医药卫生—卫生事业管理] F323.89[医药卫生—公共卫生与预防医学]