首页|共同富裕视角下城乡居民医保事业发展现状及影响因素研究

共同富裕视角下城乡居民医保事业发展现状及影响因素研究

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目的:分析2021年城乡居民医保事业发展的公平性、可及性和可持续性的现状及其影响因素,为提升医保管理和服务水平提供决策参考.方法:首先,构建"城乡居民医保事业评价指标体系",计算居民医保事业发展水平总指数及其公平性、可及性、可持续性3个子系统指数;其次,借助泰尔指数测量东、中、西部三大地带的水平差异,借助空间自相关分析总指数的空间集聚性和异质性;最后,构建地理加权回归模型分析其主要影响因素.结果:居民医保事业发展水平存在省际差异,在地理上表现为由东向西递减的趋势,在空间上呈现随机分布格局;政策因素、经济因素、人口结构、医疗资源配置和教育水平对医保事业发展水平具有显著影响.结论:建议多层次推进医保公平性,全方位增强医保可及性,动态提升医保可持续性,进一步提升管理和服务水平,增强群众医保体验感、获得感和幸福感.
Research on the Development Status and Influencing Factors of Medical Insurance for Urban and Rural Residents from the Perspective of Common Wealth
Objective:To analyze the status quo and influencing factors of the equity,accessibility and sustainability of the development of medical insurance for urban and rural residents in 2021,and provide a reference for improving the management and service level of medical insurance.Methods:Firstly,the"evaluation index system of medical insurance for urban and rural residents"was constructed,and the total index of the development level of medical insurance and its three subsystem indexes of equity,accessibility and sustainability were calculated.Secondly,the Theil index was used to measure the level differences of the three major regions in the east,central and west,and the spatial auto-correlation was used to analyze the spatial agglomeration and heterogeneity distribution pattern of the total index.Finally,a geographic weighted regression model was constructed to analyze the main influencing factors.Results:There were provincial differences in the development level of medical insurance,which showed a decreasing trend from east to west in geography and a random distribution pattern in space.Policy factors,economic factors,population structure,medical resource allocation and education level had a significant impact on the development level of medical insurance.Conclusions:It is proposed to promote the fairness at multiple levels,enhance the accessibility in all directions and dynamically improve the sustainability,and further explore the policy suggestions to improve the management and service level and enhance the residents'sense of experience,sense of gain and sense of happiness.

medical insurance for urban and rural residentsequityaccessibilitygeographic weighted regression

时涛、秦大伟、邢鲁民、王思冉、张家豪、聂雷

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山东第一医科大学(山东省医学科学院)医疗保障学院 济南 250117

临沂市人民医院临沂市医院DRG管理与应用重点实验室 山东 临沂 276000

山东第一医科大学第一附属医院(山东省千佛山医院)数据开放技术创新实验室 济南 250014

山东省卫生健康委员会医疗管理服务中心 济南 250014

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城乡居民医保 公平性 可及性 地理加权回归

山东省社科联人文社会科学课题重点项目济南市医疗保障局委托重点项目山东省卫生健康委医疗管理研究中心委托项目潍坊医学院附属医院科技发展项目

2023—ESDZ—019202101SDWJYJ2023LM010162023FYZ003

2024

中国卫生经济
中国卫生经济学会,卫生部卫生经济研究所

中国卫生经济

CSTPCDCHSSCD北大核心
影响因子:1.524
ISSN:1003-0743
年,卷(期):2024.43(6)