我国城乡居民基本医疗保险制度运行效率及影响因素研究  

Research on the operation efficiency of the basic medical insurance system for urban and rural residents in China and its influencing factors

作　　者：张礼亮 田佳帅 张婧怡 代珊珊 蔡心雨 高广颖 ZHANG Li-liang;TIAN Jia-shuai;ZHANG Jing-yi;DAI Shan-shan;CAI Xin-yu;GAO Guang-ying(School of Public Health,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学公共卫生学院,北京100069

出　　处：《中国卫生政策研究》2024年第1期68-74,共7页Chinese Journal of Health Policy

基　　金：国家自然科学基金项目(71874113)。

摘　　要：目的:研究2020—2021年我国城乡居民基本医疗保险制度的运行效率及影响因素,为提高基本医保运行效率、优化投入产出关系提供参考依据。方法:运用基于非期望产出的超效率SBM模型和Malmquist指数测算我国31个省份居民医保的静态效率、动态效率,并采用Tobit回归分析其影响因素。结果:全国居民医保整体运行效率仍有待改进;中、西部地区运行效率低于东部地区,且差距较大;不同层次和区域的运行效率存在不同的制约因素。动态效率方面,居民医保运行的全要素生产率整体呈上升趋势,主要原因是技术进步的提高。老龄化程度、医疗费用水平和医保监管水平对居民医保运行效率有显著影响。建议:应努力弥合地区差距,促进医保公平发展;合理控制医疗费用水平,加大医保基金监管力度;实施积极老龄化政策。Objective:Operational efficiency and influencing factors of China's basic medical insurance system from 2020 to 2021 is conducted to provide reference for improving the operational efficiency and optimizing the input-output relationship.Methods:The super-efficiency SBM model based on unexpected output and the Malmquist index are used to measure the static and dynamic efficiency of resident medical insurance in 31 provinces in China,and Tobit regression analysis is employed to analyze the influencing factors.Results:The overall operational efficiency of resident medical insurance still needs improvement.The operational efficiency of resident medical insurance in the central and western regions is lower than that in the eastern region,and the gap is significant.Different levels and regions have differentiated main constraints on the operational efficiency of resident medical insurance.In terms of dynamic efficiency,the total factor productivity of resident medical insurance operation shows an increasing trend,mainly due to technological progress.In terms of influencing factors,the degree of aging,the level of medical expenses and the level of medical insurance supervision have a significant impact on the operational efficiency.Suggestions:Efforts should be made to bridge regional disparities,promote the equitable development of medical insurance,reasonably control the level of medical expenses,strengthen the supervision of medical insurance funds,and implement active aging policies.

关 键 词：城乡居民基本医疗保险 超效率SBM MALMQUIST指数 TOBIT 影响因素 

分 类 号：R197[医药卫生—卫生事业管理]