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广西新型农村合作医疗保险运行效率评价
作者:何崇伟1 罗小娟1 2 韦征1 黄高明1▲ 
单位:(1.广西医科大学生物统计学教研室 2.广西疾病预防控制中心办公室 南宁530021) 
关键词:新型农村合作医疗保险 三阶段DEA模型 三阶段Malmquist模型 运行效率 
分类号:R197.1;F323.89
出版年,卷(期):页码:2019,47(6):461-467
摘要:

目的 评估广西2010~2016年新型农村合作医疗保险运行效率。方法 基于广西74个县(市)2010~2016年新型农村合作医疗保险面板数据,采用三阶段DEA模型和三阶段Malmquist模型从静、动态角度开展效率评价。结果 2010~2016年新型农村合作医疗保险收支水平、补偿人次数、补偿额度以及实有医技人员数、实有床位数增长迅速,2016年参保率达到99.87%,人均筹资为573.38元,基金使用率最高为86.32%;地区经济发展和医疗服务水平对保险的运行效率影响显著,综合技术效率均值为0.894,纯技术有效率和有效占比总体呈增长趋势,全要素生产率累计下降28.8%,技术退步是下降的主要原因。结论 广西新型农村合作医疗保险运行良好,疾病保障范围和患者受益程度显著提高,但制度效率下降明显,基金使用效率低于预期。下一步需注重提高管理水平,增加经济和医疗强县的卫生投入,建立一套科学准确的测算体系。
 

Objective To estimate the operational efficiency of new rural cooperative medical system in Guangxi from 2010 to 2016.Methods Based onthe data of the new rural cooperative medical insurance system of 74 counties(cities) in Guangxi from 2010 to 2016,three-stage DEA model and three-stage Malmquist model were adopted to evaluate the new rural cooperative medical insurance from both static and dynamic perspectives.Results From 2010 to 2016,income and expenditure levels,the number of compensators,the limit of compensation,the number of medical technicians and the number of beds in hospitals of the new rural cooperative medical insurance increased rapidly.In 2016,the rate of participating insurancereached 99.87%,per capita financing was 573.38 yuan,and the highest fund utilization rate was 86.32%.Regional economic development and medical service level have significant impacts on the operational efficiency of insurance,average comprehensive technical efficiency was 0.894,the total efficiency and effective proportion of pure technology showed an increasing trend,total factor productivity declined by 28.8%,and technological retrogression was the main reason for the decline.Conclusion The new rural cooperative medical insurance system in Guangxi is in good condition,the range of the disease coverage and patient benefit improve significantly,butsystem efficiency drop obviously,and the use efficiency of insurance fund is lower than expected.It is necessary to improve medical insurance management level,increase health input in counties with developed economy and health care,and establish a set of scientific and accurate measurement system.

基金项目:
国家自然科学基金(81260450)
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