摘要
目的:在2017—2019省级面板数据的基础上,对各省份城乡居民医保基金的运行效率进行评估。方法:首先利用产出导向的BCC模型、DEA-Malmquist指数模型分别进行静态和动态效率测算,然后利用Tobit模型进行影响因素分析,为改善城乡居民医保基金的运行效率提供科学参考。结果:全国大部分省份处于非效率前沿,整体效率水平偏低,地区排名依次为东、中、西部,且东部属于高投入、高效率类型,中西部属于低投入、低效率类型;全国城乡居民医保基金全要素生产率指数呈上升趋势,东中部地区的全要素生产率指数都略有下降,只有西部的情况在改善;人均GDP对城乡居民医保基金的运行效率有显著正向促进作用,而老年人口抚养比对其有显著负向抑制作用。结论:规模效率偏低是制约城乡居民医保基金运行效率的重要原因,因此,应进一步调整投入与产出结构,实现规模经济;在适度加大财政补贴、提高缴费标准的基础上逐渐探索建立与城乡居民收入水平挂钩的动态筹资机制,并通过实施鼓励生育、完善公共服务供给等系列配套政策来优化人口年龄结构,进而提升城乡居民医保基金的运行效率。
Objective:To evaluate the operational efficiency of medical insurance funds for urban and rural residents in all provinces of China based on the 2017—2019 provincial panel data.Methods:Output-oriented BCC model and DEA-Malmquist index model were first used to respectively estimate the static and dynamic efficiency,and then Tobit model was used to analyze the impact of influencing factors,which provided scientific references for formulating strategies to improve the operation efficiency of urban and rural residential medical insurance fund.Results:The operation of medical insurance funds in most provinces of China is at the frontier of inefficiency,with the overall efficiency level being relatively low.The regional ranking of efficiency is in the order of:eastern,middle and western.Among them,the eastern region is operating in a high-investment high-efficiency mode,whereas both middle and western regions are operating in a low-investment low-efficiency mode.Although the total factor productivity index of the national medical insurance funds for urban and rural residents is showing an overall upward trend,that index is slightly decreasing in both eastern and central regions,and only increasing in the western region.Per capita GDP has a significant positive impact on the operational efficiency of urban and rural residential medical insurance funds,while the elderly dependency ratio has a significant negative impact.Conclusions:Relatively low scale efficiency is currently a crucial limiting factor for the operational efficiency of urban and rural residential medical insurance funds.Therefore,in order to improve the operational efficiency of urban and rural residential medical insurance funds,the government is suggested to further adjust the input and output structure to achieve scale economy,adequately increase financial subsidies and payment standards,step-by-step explore the establishment of a dynamic financing mechanism compatible to the income level of urban and rural residents,and implement a series of support
作者
于凌云
于梦迪
YU Ling-yun;YU Meng-di(Southwest Jiaotong University School of Public Administration, Chengdu Sichuan 610031, China)
出处
《中国卫生政策研究》
CSCD
北大核心
2021年第10期31-37,共7页
Chinese Journal of Health Policy
基金
2018年度教育部人文社会科学研究规划基金项目(18YJAZH117)。
关键词
城乡居民
医保基金
运行效率
影响因素
Urban and rural residents
Basic medical insurance funds
Operating efficiency
Influencing factors
