基于GM(1,1)模型的上海市城镇职工基本医疗保险基金结余预测分析  

Basic Medical Insurance Fund for Urban Workers in Shanghai Based on GM(1,1) Model Balance Prediction Analysis

作　　者：郑明玉 

机构地区：[1]上海工程技术大学,管理学院,上海

出　　处：《运筹与模糊学》2023年第5期5258-5265,共8页Operations Research and Fuzziology

摘　　要：上海市城镇职工基本医疗保险基金作为上海市基本医保的主体,是保障民生福祉和维护社会稳定的关键一环。本文以2009~2021年上海市城镇职工医疗保险基金相关数据为基础,通过建立GM(1,1)模型对2022~2030年的职工医保基金收支规模及结余趋势进行预测,结果显示基金规模将不断扩大,基金累计结余呈现持续上涨态势。基金的过度沉淀将会破坏医保基金共建共享、风险共济的保障效能,不利于职工医保基金的可持续发展。因此,优化上海市职工基本医疗保险内部结构,进一步提升高额基金结余的使用效率是当前亟待解决的问题。As the main body of basic medical insurance in Shanghai, the basic medical insurance fund for urban workers in Shanghai is a key link to ensure the well-being of people’s livelihood and maintain social stability. Based on the relevant data of Shanghai urban employee medical insurance fund from 2009 to 2021, this paper predicts the income and expenditure scale and balance trend of employee medical insurance fund from 2022 to 2030 by establishing GM(1,1) model. The results show that the scale of the fund will continue to expand, and the cumulative balance of the fund will continue to rise. The excessive precipitation of the fund will destroy the guarantee efficiency of the co-construction and sharing of the medical insurance fund and the risk sharing, which is not conducive to the sustainable development of the employee medical insurance fund. Therefore, it is an urgent problem to optimize the internal structure of the basic medical insurance for employees in Shanghai and further improve the efficiency of the use of high fund balances.

关 键 词：上海市 城镇职工医保 基金结余 灰色系统理论 GM(1 1)模型 

分 类 号：F83[经济管理—金融学]