人口老龄化对我国基本医疗保险基金结余可持续发展的影响研究  

The Impact of Population Ageing on the Sustainable Development of China’s Basic Medical Insurance Fund Balance

作　　者：胡芳[1] 王磊鑫 覃钰雯 Hu Fang;Wang Leixin;Qin Yuwen(School of Economics,Guangxi University,Nanning,Guangxi,530004,China)

机构地区：[1]广西大学经济学院,广西南宁530004

出　　处：《中国卫生经济》2024年第7期36-41,共6页Chinese Health Economics

基　　金：国家自然科学基金项目(71861001);广西高校人文社会科学重点研究基地课题(2023GDSIQM16);2023年大学生创新创业训练计划项目(S202310593167)。

摘　　要：目的:预防人口老龄化可能带来的影响,找出确保基本医疗保险基金结余可持续发展的对策。方法:运用系统动力学,通过耦合基本医疗保险基金收入、基本医疗保险基金支出、人口数量三大子系统,绘制因果关系图与存量流量图,从而构建系统动力学模型,并利用Vensim软件进行仿真模拟。结果:预测的自然情形下,基本医疗保险基金结余在2023—2030年呈现出先上升后下降的趋势。将退休策略、门诊次数和参保率3个变量进行调控设计并组合成为4种解决方案,其中同时实施延迟退休、扩大基本医疗保险覆盖面和加强老年人健康管理的预测方案4可大幅度减少基本医疗保险基金的下降幅度。结论:人口老龄化不利于基本医疗保险基金结余可持续发展,据此提出相关建议:实施适当的延迟退休政策,实现基本医疗保险基金收入增加;进一步扩大参保覆盖面,强化基本医疗保险基金的抗风险能力;加强老年人健康管理,控制基本医疗保险基金支出过快增长。Objective:To prevent the possible effects of population aging and find out countermeasures to ensure the sustainable development of basic medical insurance fund balances.Methods:Using system dynamics,by coupling the three subsystems of basic medical insurance fund income,basic medical insurance fund expenditure,and population size,a causal relationship diagram and stock flow diagram are drawn to construct a system dynamics model,and Vensim Software is used for simulation.Results:Under the predicted natural conditions,the balance of the basic medical insurance fund will show a trend of first increasing and then decreasing from 2023 to 2030.Adjusting and combining the three variables of retirement strategy,outpatient visits,and participation rate into four solutions,among which simultaneously implementing the prediction plan of delaying retirement,expanding basic medical insurance coverage,and strengthening elderly health management can significantly reduce the decline of the basic medical insurance fund.Conclusion:The aging population will be detrimental to the sustainable development of the surplus of the basic medical insurance fund.Based on this,the following suggestions are proposed:implement appropriate delayed retirement policies to increase the income of the basic medical insurance fund;further expand the coverage of insured individuals to enhance the risk resistance of the basic medical insurance fund;strengthen the health management of the elderly to control the excessively rapid growth of the basic medical insurance fund expenditures.

关 键 词：基本医疗保险 基金结余 可持续发展 人口老龄化 系统动力学 

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]