| 引用本文：郑锦轩,邢若斌,宋锦涛,等.老龄化背景下我国城镇职工基本医疗保险筹资与支付协同度分析[J].中国卫生政策研究,2025,18(10):24-31 |
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| 老龄化背景下我国城镇职工基本医疗保险筹资与支付协同度分析 |
| 投稿时间：2025-09-16 修订日期：2025-10-10 PDF全文浏览 HTML全文浏览 |
| 郑锦轩1，邢若斌1，宋锦涛1，马延涛1，阳宛谕2，曾雁冰1 |
| 1.首都医科大学公共卫生学院 北京 100069;2.海南医科大学公共卫生学院 海南海口 571199 |
| 摘要:目的 分析老龄化背景下我国城镇职工基本医疗保险筹资与支付的协同关系，为推进城镇职工基本医疗保险筹资与支付协同发展提供决策依据。方法 基于医疗保障等统计年鉴数据，运用德尔菲法明确老龄化背景下城镇职工医保筹资与支付协同分析指标；运用协同理论构建我国城镇职工医保筹资与支付复合系统协同度模型，并测算城镇职工医保筹资与支付系统有序度与复合系统协同度。结果 老龄化背景下我国城镇职工基本医疗保险筹资系统有序度从2019年的0.324增至2023年的0.517；支付系统有序度从2019年的0.454增至2023年的0.517；但筹资与支付两系统的复合协同度处于不协同区间，2023年复合协同度为-0.084。结论 受老龄化的影响，我国城镇职工基本医疗保险筹资系统与支付系统发展速度与规模不同步，且支付系统受影响的程度大于筹资系统，使筹资与支付复合系统呈现不协同有序的发展状态。 |
| 关键词:城镇职工基本医疗保险 筹资 支付 复合系统协同度模型 |
| 基金项目:国家自然科学基金面上项目（72474143）；教育部人文社科一般项目（23YJAZH010）；北京市高层次公共卫生技术人才项目（学科骨干-03-15） |
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| Analysis on the synergy degree between financing and payment of basic medical insurance for urban workers in China under the background of aging |
| ZHENG Jin-xuan1, XING Ruo-bin1, SONG Jin-tao1, MA Yan-tao1, YANG Wan-yu2, ZENG Yan-bing1 |
| 1.School of Public Health， Capital Medical University， Beijing 100069， China;2.School of Public Health， Hainan Medical University， Haikou Hainan 571199， China |
| Abstract:Objective To analyze the synergistic relationship between financing and payment systems in China's urban employee basic medical insurance under the background of aging， providing decision-making basis for promoting coordinated development of these two systems.Methods Based on statistical yearbook data from medical security systems， the Delphi method was employed to identify collaborative analysis indicators for urban employee medical insurance financing and payment under the aging population context. A collaborative theory-based model was constructed to measure the coordination degree of China's urban employee medical insurance financing and payment composite system， while simultaneously assessing the orderliness of the financing and payment system and the coordination degree of the composite system.Results The order degree of the financing system ranged from 0.324 in 2019 to 0.517 in 2023； the order degree of the payment system ranged from 0.454 in 2019 to 0.517 in 2023； the synergy degree of both systems reached -0.084 in 2023.Conclusions Influenced by aging， the development speed and scale of China's urban employee basic medical insurance financing system and payment system are asynchronous， with the payment system being more affected than the financing system， resulting in a non-coordinated and disordered development state of the composite financing-payment system. |
| Key words:Basic medical insurance for urban workers Financing Payment Composite system synergy model |
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