基于动态面板数据模型的居民医保筹资负担收敛分析  

Convergence Analysis of Resident Medical Insurance Financing Burden Based on Dynamic Panel Model

作　　者：秦大伟[1] 张家豪 时涛 王思冉 曹养栋 张涛 Qin Dawei;Zhang Jiahao;Shi Tao;Zhang Tao(Key Laboratory for Linyi Hospital DRG Management and Application,Linyi People's Hospital,Linyi,Shandong,276000,China)

机构地区：[1]临沂市人民医院临沂市医院DRG管理与应用重点实验室,山东临沂276000 [2]山东第一医科大学(山东省医学科学院)医疗保障学院,济南250117 [3]济南市章丘区急救指挥中心,济南250200

出　　处：《中国卫生经济》2024年第5期48-52,共5页Chinese Health Economics

基　　金：山东省社科联人文社会科学课题重点项目(2023-ESDZ-019);济南市医疗保障局委托重点项目(202101);山东省卫生健康委医疗管理研究中心委托项目(SDWJYJ2023LM01016);潍坊医学院附属医院科技发展项目(2023FYZ003)。

摘　　要：目的:通过分析2015—2022年山东省居民医保“个人缴费负担比”和“政府补助负担比”的面板数据,研究筹资负担的时间演变规律,评估省级统筹的可行性。方法:运用空间自相关分析,对各时间截面数据进行空间集聚性和异质性格局探究;借助收敛分析探讨筹资负担的年际变化趋势。结果:“个人缴费负担比”逐年增加且各地市间差异显著;Moran’s I值逐年减小,在地理上呈现随机分布格局;“政府补助负担比”在各地市间差异较小,全局Moran’s I值逐年增大,空间集聚格局增强;两者均存在σ收敛和绝对β收敛,呈现均衡发展的趋势。结论:为推进省级统筹、保障医保基金安全、减轻居民负担,可采取经济协同发展策略以提高居民收入;建议注重开源节流,精细基金监管;应改革筹资机制,制定精细筹资标准,并聚焦疾病预防控制费用的增长,为完善医保制度、促进医保事业的可持续发展提供参考。Objective:To study the time evolution of financing burden and discuss the feasibility of provincial pooling by analyzing the panel data of“individual contribution burden ratio”and“government subsidy burden ratio”of residents'medical insurance in Shandong Province from 2015 to 2022.Methods:Spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity pattern;convergence analysis was used to analyze the inter-annual trends in the economic burden.Results:The“out-of-pocket ratio”increased year by year and the difference among cities was significant,the Moran's I value decreased year by year,and the geographical distribution pattern showed a random distribution pattern;the“government subsidy burden ratio”had little difference among cities,the global Moran's index value increased year by year,and the spatial agglomeration pattern was enhanced;both of them hadσconvergence and absoluteβconvergence,showing a trend of balanced development.Conclusion:In order to promote provincial-level coordination,safeguard fund security and reduce the burden on residents,economic synergistic development strategies have been adopted to raise residents'incomes;emphasis has been placed on cutting back on income and expenditure,fine-tuning fund supervision;and reforming the financing mechanism,formulating fine-tuning financing standards and focusing on the increase in the cost of disease prevention and control have been adopted,so as to provide references for the improvement of the health insurance system and the promotion of the sustainable development of the health insurance cause.

关 键 词：居民医保 筹资负担 动态面板模型 收敛分析 山东 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] F840.613[经济管理—保险]