退休对职工医保住院费用的影响研究——以福建省某市为例  

Research on the Impact of Employee Retirement on the Healthcare Security Expenses for Medical Insurance——Taking a City in Fujian Province as an Example

作　　者：陈金婵 李跃平[1,2] 

机构地区：[1]福建医科大学卫生管理学院,福州350122 [2]福建医科大学图书馆,福州350122

出　　处：《中国医疗保险》2024年第2期92-96,共5页China Health Insurance

基　　金：福建省新型智库重大研究课题之第十一次党代会前期研究“全面加强公共卫生服务体系建设研究”(21MZKB09)。

摘　　要：目的:人口老龄化逐步加深,探讨退休对职工住院费用的影响,为医保制度完善和退休政策制定提供实证参考。方法:利用模糊断点回归对福建省某市2017年职工医保参保人住院医保结算数据进行分析。结果:退休使职工住院总费用、报销费用、统筹基金支出和总基金支出显著增加,对个人账户支出和现金支出变化影响并不显著。退休对职工住院费用的影响存在性别差异,对非公务员群体与非慢性病群体的住院费用影响较大。结论:退休后职工住院费用显著增加,群体间差异明显。建议加强门诊医疗保障力度,提高医疗资源配置效率;促进多层次医疗保障有序衔接,减轻老年患者就医经济负担,探索推行弹性退休年龄政策。Objective:With the deepening of aging population,the paper explores the impact of retirement on employee hospitalization costs to provide empirical reference for improving the medical insurance system and formulating policies for retirement.Methods:The paper uses fuzzy regression discontinuity design to analyze the hospitalization medical insurance settlement data of employee medical in a city of Fujian Province in 2017.Results:Retirement has a significant impact on total hospitalization expenses,reimbursement expenses,pooling fund expenditures,and total fund expenditures,but no significant correlation was found between personal account expenditures and cash expenditures.There is a gender difference in the impact of retirement on the hospitalization expenses of employees,with a greater impact on the hospitalization expenses of non-civil servants and non-chronic disease groups.Conclusion:The hospitalization expenses of retired employees have significantly increased,with significant differences between groups.It is suggested to strengthening outpatient healthcare security,improving the efficiency of medical resource allocation,promoting the orderly connection of multi-level healthcare security and reduce the economic burden of elderly patients seeking medical treatment,and exploring a flexible retirement policy.

关 键 词：退休 职工医保 住院费用 

分 类 号：F840.684[经济管理—保险] C913.7[社会学]