我国中央与地方政府基本医疗保险财政支出的划分比例研究  

Study on the Divided Proportion of Financial Expenditure of Basic Medical Insurance Between Central and Local Governments in China

作　　者：席晓宇[1] 李文君 张婧[1] 黄蓉 XI Xiao-yu;LI Wen-jun;ZHANG Jing(The Research Center of National Drug Policy&Ecosystem,China Pharmaceutical University,Nanjing,Jiangsu,211198,China;不详)

机构地区：[1]中国药科大学国家药物政策与医药产业经济研究中心,江苏南京21119

出　　处：《中国医院管理》2020年第12期18-22,共5页Chinese Hospital Management

基　　金：江苏高校哲学社会科学研究基金项目(2017SJB0053);中国药科大学“双一流”学科创新团队建设项目(CPU2018GY39)。

摘　　要：目的结合我国中央与地方基本医疗保险财政支出划分实际情况,展开我国不同层级政府间基本医疗保险支出责任划分分析,确定中央与地方各自的分配比重。方法根据有关数据,基于收支平衡可持续视角展开分配比例测算,并与现阶段责任划分策略展开对比分析。结果中央与地方政府支出分担水平依据各省份情况划分为5档:不可持续、短期可持续、中期可持续、中长期可持续、长期可持续。分档层次与现阶段责任划分策略的分档层次类似,但分档比例更加精确。结论为有效控制基本医疗保险财政支出的不可持续风险,需要根据地方财政可持续进行中央与地方支出责任的科学划分。Objective Based on the actual situation of the division of basic medical insurance expenditure between the central and local governments in China,the division and analysis of basic medical insurance expenditure responsibilities among different levels of governments in China were carried out to further determine the distribution proportion between the central and local governments.Methods According to the relevant data of medical insurance fiscal expenditure,the allocation proportion was calculated based on the sustainable perspective of basic medical insurance revenue and expenditure balance,and compared with the current responsibility division strategy.Results The level of central and local government expenditure sharing is divided into five grades according to the sustainable situation of basic medical insurance expenditure in each province:unsustainable,short-term sustainable,medium-term sustainable,medium-term sustainable and long-term sustainable.The classification level is similar to the classification level proposed in the current responsibility classification strategy,but the classification ratio is more accurate than the current strategy.Conclusion In order to effectively control the unsustainable risks of the fiscal expenditure of basic medical insurance,it is necessary to scientifically divide the central and local expenditure responsibilities according to the sustainability of local finance.

关 键 词：财政支出 基本医疗保险 中央政府 地方政府 

分 类 号：R197.1[医药卫生—卫生事业管理]