广西基本医疗保险运行现状及对策研究  

Research on the Current Situation and Countermeasures of Basic Medical Insurance Operation in Guangxi

作　　者：朱旭豪 王前强 

机构地区：[1]广西医科大学人文社会科学学院,南宁530021

出　　处：《中国医疗保险》2023年第8期96-100,共5页China Health Insurance

基　　金：国家社会科学基金项目(18XZZ013);广西壮族自治区卫生健康委员会广西卫生健康事业发展“十四五”规划研究及编制项目(82/03301220013D)。

摘　　要：目的:通过分析2017年—2021年广西基本医疗保险运行现状,为广西医保基金持续健康发展提供建议。方法:基于2017年—2021年广西基本医疗保险运行数据,运用SPSS软件进行分析。结果:2017年—2021年,广西职工医保参保人数持续增加,年均增长率为6.45%,居民医保参保人数小幅下降,年均增长率为-0.45%;职工医保、居民医保基金收入与支出均呈上升趋势,其中职工医保基金收入与支出年均增长率分别为13.27%和14.82%,居民医保基金收入与支出年均增长率分别为8.62%和18.84%,职工医保、居民医保基金结余率逐年递减,由2017年的24.03%和28.55%下降至2021年的19.77%和-2.4%;职工医保、居民医保次均住院费用均逐年增长,年均增长率分别为2.51%和8.83%。结论:广西职工医保和居民医保基金结余率略有降低,基金运行压力较大,亟须建立医保基金长效监管机制,多渠道提高基金使用效率。Objective:By analyzing the operation of basic medical insurance in Guangxi from 2017 to 2021,the paper provides suggestions for the sustainable and healthy development of medical insurance fund in Guangxi.Methods:Based on the data of basic medical insurance in Guangxi from 2017 to 2021,the paper applied SPSS software for statistical analysis.Results:From 2017 to 2021,the number of employees participating in medical insurance in Guangxi continued to increase,with an average annual growth rate of 6.45%,while the number of residents participating in medical insurance decreased slightly,with an average annual growth rate of-0.45%.The income and expenditure of the medical insurance fund for employees and residents were increasing.The average annual growth rate of income and expenditure of the medical insurance fund for employees was 13.27%and 14.82%,and the average annual growth rate of income and expenditure of the medical insurance fund for residents was 8.62%and 18.84%.The balance rate of the medical insurance fund for employees and residents was decreasing year by year,from 24.03%and 28.55%in 2017 to 19.77%and-2.4%in 2021.The average hospitalization expenses of employees and residents increased year by year,with an average annual growth rate of 2.51%and 8.83%respectively.Conclusion:The balance rate of employees’and residents'medical insurance fund has slightly decreased,resulting in high pressure on the operation of funds.It is urgent to establish a long-term mechanism for the supervision of medical insurance fund,and improve the efficiency of fund use by various means.

关 键 词：基本医疗保险 社会保险 运行现状 年均增长率 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]