医保省级统筹驱动因素分析——基于地理加权回归模型  

Analysis of Driving Factors for Basic Medical Insurance Provincial Pooling——Based on Geographically Weighted Regression Model

作　　者：张家豪 张秀梅 王思冉 张茜 帅晓娟 温红娟 时涛 

机构地区：[1]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 [2]长春中医药大学管理学院,长春130117

出　　处：《中国医疗保险》2025年第4期38-47,共10页China Health Insurance

基　　金：山东省社科联2024年人文社会科学课题卫生健康专项“山东省医疗卫生服务体系新质生产力的新评价与优化提升策略研究”[24H063(Z)];山东省教育厅(本科教学改革研究项目)重点项目“新医科背景下医疗保险专业‘政产学研沿用’协同育人机制研究与实践”(Z2024219);山东省大学生创新创业计划项目“山东省居民医保筹资负担水平评估与影响因素分析”(S202410439042)。

摘　　要：目的:基于基本医疗保险省级统筹“六统一”原则,评估省级统筹发展现状及其驱动因素,为推进省级统筹提供理论支持。方法:首先从公平性、可持续性、稳健性和统一性四个维度构建“基本医疗保险省级统筹发展评价指标体系”,计算各省份发展水平总指数及各维度指数;然后借助泰尔指数测度各区域水平差异,借助空间自相关分析空间集聚性和异质性格局;最后构建地理加权回归模型分析其驱动因素。结果:各省份省级统筹的推进程度及发展水平存在显著差异,总指数在地域上表现为由东向西递减的趋势,在地理空间上呈现随机分布格局;经济水平、政策因素、医疗资源、教育投入对推动省级统筹的影响显著。结论:完善筹资机制、强化统筹协调、强化制度衔接、优化资源配置、加强人才培养,能有效推动基本医保省级统筹的进程,实现医保制度的公平性、持续性、稳健性和统一性,更好地保障人民群众的健康权益。Objective:Based on the “six unifications” principle of basic medical insurance provincial pooling,this study evaluates the current status of provincial pooling progress and its driving factors with a view to providing policy recommendations for promoting provincial pooling.Methods:Firstly,a “development evaluation index system for basic medical insurance provincial pooling” was constructed from the perspectives of fairness,sustainability,stability and unification and the overall index in each province as well as index in each dimension was calculated;then regional level differences were measured by Theil index and spatial agglomeration and heterogeneity patterns were analyzed by spatial auto-correlation;finally,the driving factors were analyzed using geographically weighted regression model.Results:There are significant differences in the progress of provincial pooling and development levels among provinces with a decreasing trend of overall index from east to west in geographical space showing a random distribution pattern.Economic level,policy factors,medical resources and educational investment have significant impacts on promoting provincial pooling.Conclusion:Improving financing mechanisms,strengthening coordination,enhancing institutional linkage,optimizing resource allocation and enhancing talent cultivation can effectively promote the process of basic medical insurance provincial pooling,achieve fairness,sustainability,stability,and unification in the medical insurance system,and better safeguarding people's health rights.

关 键 词：基本医疗保险 省级统筹 现状评价 驱动因素 地理加权回归 

分 类 号：F840.684[经济管理—保险]