基于时间序列的北京市社会医疗保障经费研究
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摘要
目的:分析基于时间序列的北京市社会医疗保障经费的构成及增长情况,评价社会医疗保障体系的发展。方法:卫生总费用筹资来源法。结果:2000—2017年北京市社会医疗保障经费总额从62.26亿元增长到1 180. 77亿元,年平均增长速度为14. 94%,占卫生总费用的比重从37.34%增长至53. 82%。社会医疗保障经费主要以四大类基本医疗保障体系为主,四大类基本医疗保障经费占社会医疗保障经费的比重由22. 82%增长至92. 67%,年均增速为24. 81%。结论:北京市社会医疗保障体系的逐步发展完善,北京市医疗保障政策的调整和变化影响了社会医疗保障经费构成变化,四大体系的筹资构成不同,体现了政府与社会在不同筹资中的责任。建议:提高基本医疗保险保障水平,规范商业健康保险的发展,关注社会医疗保险筹资增长的可持续,促进医疗保险向健康保险的发展。
Objective: Based on time series data, this paper analyzes the structure and trend of Beijing's social medical insurance funds and evaluates the development of social medical insurance system. Methods : Health financing analysis method is used to calculate the social medical insurance funds. Results: The social medical insurance funds of Beijing increased from 6.23 to 118.08 billion yuan between 2000 and 2017, with an average annual increase of 14.94%. The proportion of social medical insurance funds to total health expenditure was 53. 82%, increasing from 37. 34% in 2000. The four types of basic medical insurance systems were the main parts of the social medical insurance funds; the proportion of their expenses increased from 22. 82% to 92. 67%, with a growth rate of 24.81%. Conclusions : Beijing's social medical insurance system has been gradually developing and improving well.Changes of Beijing's medical insurance policies have positively influenced the structure of the social medical insurance funds. The financing structures of the four types of basic medical insurance systems are different, which reflects the responsibility of the government and society in different insurance financing. Suggestion: This paper suggests policymakers to improve the treatment of basic medical insurance and regulate the development of commercial health insurances,pay attention to the sustainable growth of social medical insurance financing in order to promote the transformation of medical insurance into health insurance.
Objective: Based on time series data, this paper analyzes the structure and trend of Beijing's social medical insurance funds and evaluates the development of social medical insurance system. Methods : Health financing analysis method is used to calculate the social medical insurance funds. Results: The social medical insurance funds of Beijing increased from 6.23 to 118.08 billion yuan between 2000 and 2017, with an average annual increase of 14.94%. The proportion of social medical insurance funds to total health expenditure was 53. 82%, increasing from 37. 34% in 2000. The four types of basic medical insurance systems were the main parts of the social medical insurance funds; the proportion of their expenses increased from 22. 82% to 92. 67%, with a growth rate of 24.81%. Conclusions : Beijing's social medical insurance system has been gradually developing and improving well.Changes of Beijing's medical insurance policies have positively influenced the structure of the social medical insurance funds. The financing structures of the four types of basic medical insurance systems are different, which reflects the responsibility of the government and society in different insurance financing. Suggestion: This paper suggests policymakers to improve the treatment of basic medical insurance and regulate the development of commercial health insurances,pay attention to the sustainable growth of social medical insurance financing in order to promote the transformation of medical insurance into health insurance.
引文
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[11]张研,张亮.健康中国背景下医疗保障制度向健康保障制度转型探索[J].中国卫生政策研究,2018, 11(1):2-5.
[2]王昕.社会基本医疗保障与卫生总费用的动态关系分析[J].中国卫生统计,2013, 30(1):77-82.
[3]宋燕,李静丽,甄天明.山东省社会医疗保障水平的测量及适宜度[J].中华医学图书情报杂志,2017, 26(5):22-24.
[4]夏迎秋,景鑫亮,段沁江.我国城乡居民基本医疗保险制度衔接的现状、问题与建议[J].中国卫生政策研究,2010, 3(1):43-48.
[5]孙蕾,王峰.医疗保障城乡统筹的思考[J].中国卫生标准管理,2017, 8(13):31-33.
[6]苗艳青,王禄生.城乡居民基本医疗保障制度案例研究:试点实践和主要发现[J].中国卫生政策研究,2010, 3(4):9-14
[7]应亚珍,潘伟,张朝阳.加大保障力度,改善医疗服务公平性-新农合与医疗救助制度的衔接机制及成效分析[J].中国卫生政策研究,2015, 8(11):3-8.
[8]王保真,徐宁,孙菊.统筹城乡医疗保障的实质及发展趋势[J].中国卫生政策研究,2009, 2(8):32-35.
[9]北京市统计局.2016北京统计年鉴[M].北京:中国统计出版社,2016.
[10]严晓玲,王洪国,陈洪敬,等.新医改环境下我国商业健康保险发展的现状、问题与对策[J].中国卫生政策研究,2013, 6(5):50-54.
[11]张研,张亮.健康中国背景下医疗保障制度向健康保障制度转型探索[J].中国卫生政策研究,2018, 11(1):2-5.