医养结合政策对我国职工基本医疗保险基金支出的影响  

Impact of the Policy of Combined Medical and Elderly Care Services on the Expenditure of Basic Medical Insurance Fund for Employees in China

作　　者：刘小青 刘光栋 詹天翔 吴雅菲 冯怡婷 胡江帆 LIU Xiaoqing(School of Public Finance and Administration,Tianjin University of Finance and Economics,Tianjin,300222,China)

机构地区：[1]天津财经大学财税与公共管理学院,天津300222 [2]天津财经大学商学院,天津300222 [3]天津财经大学统计学院,天津300222

出　　处：《医学与社会》2024年第12期105-111,共7页Medicine and Society

基　　金：教育部人文社会科学研究青年基金项目资助(基于城乡一体化过程的医疗保险风险调整机制研究,19YJC840027)。

摘　　要：目的:探究医养结合政策对我国职工基本医疗保险基金支出的影响,为进一步完善医养结合政策和优化职工基本医疗保险基金运行机制提供参考。方法:以医养结合政策的实施为准自然实验,运用双向固定双重差分模型,选取2015-2020年职工年末参保人数、职工基本医疗保险基金支出等数据分别进行基本情况分析、影响结果分析、稳健性分析、机制分析及差异性分析。结果:医养结合政策的实施对职工基本医疗保险基金支出的影响结果分析表明,Treat_(i)*Policy_(t)的系数所展现的结果均为正数,在5%的水平上较为明显;对医疗卫生机构数的机制分析和影响结果分析中的Treat_(i)*Policy_(t)的系数均在1.45附近,显著性在5%范围内;差异性分析中,东部、中部、西部地区解释变量的系数为正且显著,影响系数分别为0.348、0.282、0.214。结论:医养结合政策会在一定程度上增加职工基本医疗保险基金支出;增加医疗卫生机构数是增加职工基本医疗保险基金支出的重要传导机制;医养结合政策对我国不同地区职工基本医疗保险基金支出的刺激程度不均,其中东部地区受影响最大。应进一步完善医养结合政策,对职工基本医疗保险基金支出的结构做进一步研究;促进医保资源和医疗服务资源的优化配置,提高医养结合政策的落实水平。Objective:To explore the impact of the policy of combined medical and elderly care services on the expenditure of basic medical insurance fund for employees in China,in order to provide reference for further improving the policy of combined medical and elderly care services and optimizing the operation mechanism of the basic medical insurance fund.Methods:Taking the implementation of the policy of combined medical and elderly care services as a quasi-natural experiment,and using a two-way fixed difference-in-differences model,the data on the number of employees enrolled at the end of the year and expenditures of basic medical insurance fund for employees from 2015 to 2020 are selected to carry out the basic status and impact analysis,the robustness test,the channel test and the heterogeneity test,respectively.Results:The analysis of the impact of the implementation of the policy of combined medical and elderly care services on the expenditure of basic medical insurance fund for employees shows that the coefficient of Treat_(i)*Policy_(t)is positive and more significant at the 5%level.The coefficient of Treat_(i)*Policy_(t)in the mechanism analysis and impact analysis of the number of medical and health institutions is around 1.45,with significance within the 5%range.In the analysis of differences,the coefficients of explanatory variables in the eastern,central,and western regions are positive and significant,with impact coefficients of 0.348,0.282,and 0.214,respectively.Conclusion:The expenditure of basic medical insurance fund for employees increases significantly after the implementation of the policy of combined medical and elderly care services.The increase in the number of medical care and health care institutions is an important conduction mechanism for the increase in the expenditure of basic medical insurance fund for employees.The policy of combined medical and elderly care services increases the expenditure of basic medical insurance fund for employees in China's east,middle and west regions.The degree

关 键 词：职工基本医疗保险 基金支出 医养结合 

分 类 号：R-05[医药卫生] R197.1