医疗保险态势与结构优化影响因素研究——基于人口结构变迁的视角

Research on the Influencing Factors of Medical Insurance Situation and Structure Optimization——Based on the Perspective of Demographic Changes

现阶段我国人口结构变迁主要呈现出人口老龄化和城镇化的趋势特征,根据决策实验室法(DEMATEL)在众多反映人口结构变迁指标中确定三个关键指标:死亡率、老年抚养系数、城镇化率,基于1997—2017年的数据构建结构向量自回归模型(SVAR),分析我国人口结构变迁因素对社会医疗保险和商业健康险需求的影响。研究结果表明,人口结构变迁对医疗保险结构具有显著影响,商业健康险与社会医疗保险二者之间存在互为正向的影响关系。建议建立多层次医疗保障体系,统筹城乡及区域资源、优化医疗保险基金筹资和分配方式。

At this stage,China's demographic changes mainly show the characteristics of population aging and urbanization.According to the Decision Making Trial and Evaluation Laboratory,DEMATEL,three key factors are identified among the factors affecting residents'medical insurance needs:the mortality,the old-age dependency ratio,and the urban population ratio.Based on the data from 1997 to 2017,the structural vector autoregressive model(SVAR)is used to characterize the influence of the main key factors of China's population structure on demand of social medical insurance and commercial health insurance.The research results show that population structure changes have a significant impact on the medical insurance structure,and there is a positive relationship between social medical insurance and commercial health insurance.Based on this,we propose policy recommendations for establishing a multi-level medical security system,coordinating urban and rural and regional resources,and optimizing the financing and distribution methods of medical insurance funds.