| 引用本文：周晓媛, 何月, 范少瑜, 张引颖.基于投入—产出视角的职工医保和居民医保对比分析——以四川省21个统筹地区为例[J].中国卫生政策研究,2020,13(9):62-67 |
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| 基于投入—产出视角的职工医保和居民医保对比分析——以四川省21个统筹地区为例 |
| 投稿时间：2020-07-07 修订日期：2020-08-24 PDF全文浏览 HTML全文浏览 |
| 周晓媛, 何月, 范少瑜, 张引颖 |
| 四川大学华西公共卫生学院 华西第四医院 四川成都 610041 |
| 摘要:目的：本文在建立和发展多层次医疗保障体系的背景下，从投入-产出的角度对不同基本医疗保险作对比分析，以参保人的视角探索职工医保和居民医保投入-产出存在的问题，为进一步完善多层次医疗保障体系提供参考依据。方法：运用经济学中成本（投入）-效果（产出）评价方法，采用住院实际补偿比作为产出指标，测算两类保险的绝对成本和相对成本，分析两类基本医保的投入-产出比和增量成本效果比。结果：21个统筹地区职工医保人均缴纳保费（绝对成本）是居民医保的5~12倍，职工医保缴费占比（相对成本）约为居民医保的3~7倍。居民医保的投入-产出比是职工医保的2~5倍，有两个地区的居民医保具有绝对成本-效果优势。结论：对参保人员而言，职工医保人均投入远超过居民医保；职工医保基金的投入产出效率低于居民医保；职工医保的成本-效果优势将逐渐弱化。 |
| 关键词:城镇职工基本医疗保险 城乡居民基本医疗保险 投入产出比 增量成本效果比 |
| 基金项目:四川省医研会专项基金（19H1167） |
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| Comparative analysis on UEBMI and URRBMI from input-output perspective: Based on 21 overall planning regions in Sichuan Province |
| ZHOU Xiao-yuan, HE Yue, FAN Shao-yu, ZHANG Yin-ying |
| West China school of public health West China Fourth Hospital, Sichuan University, Chengdu Sichuan 610041, China |
| Abstract:Objective:Under the background of establishing and developing a multi-level medical security system, this article makes a comparative analysis of different basic medical insurances from the perspective of input-output, and to explore the input-output problems of Urban Employed Basic Medical Insurance (UEBMI) and Urban-rural Residency Basic Medical Insurance (URRBMI) from the perspective of insured, so as to provide reference basis for the further improving the multi-level medical security system. Methods:This research was conducted using the cost (input)-effect (output) evaluation method in economics, taking the actual hospitalization compensation ratio as the output indicator, measuring the absolute and relative costs of the two types of insurance, and analyzing the input-output ratio and incremental cost-effective ratio (ICER) of the two types of basic medical insurance. Results:The per capita UEBMI (absolute cost) premium in 21 overall planning areas was 5 to 12 times that of URRBMI and the proportion of UEBMI (relative cost) premium was about 3 to 7 times that of URRBMI. The URRBMI input-output ratio was 2 to 5 times that of URRBMI, and URRBMI in two regions had an absolute cost-effectiveness advantage (ACEA) over UEBMI. Conclusions:The per capita UEBMI input is far greater than that of URRBMI from the perspective of the insured, the UEBMI input-output efficiency is lower than that of URRBMI; and the UEBMI's cost-effectiveness advantage will gradually weaken. |
| Key words:Urban Employed Basic Medical Insurance(UEBMI) Urban-rural Residency Basic Medical Insurance(URRBMI) Input-output ratio Incremental cost-effectiveness ratio |
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