基于fsQCA组态视角的医保基金支出影响因素分析

Analysis of Influencing Factors of Medical Insurance Fund Expenditure Based on fsQCA Configuration

目的:分析促使医保基金支出增长的多元影响因素,为医保基金可持续发展提供参考。方法:运用模糊集定性比较分析方法,选取人口老龄化、经济发展、医疗资源供给、医疗费用、医疗技术水平、政府卫生支出与城镇化7个条件变量,探讨促使医保基金支出增长多元因素的组态构型与作用路径。结果:从单一因素研究医保基金支出增长不尽全面,因为医保基金支出通过条件组态形式发挥作用。7个条件变量形成了3种促使医保基金支出增长的组态解,总体一致性为0.96,总体覆盖度为0.64。结论:医保基金支出增长是多种因素协同作用的结果,不同因素在不同组态中的作用存在差异。可从提升医保基金支出治理的针对性等方面合理控制基金支出增长过快问题,促进医保基金良性运转。

Objective:The paper analyzes the multiple factors that promote the growth of medical insurance fund expenditure to provide reference for the sustainable development of medical insurance fund.Methods:The fuzzy set qualitative comparative analysis method was used to select seven conditional variables,namely population aging,economic development,medical resource supply,medical cost,medical technology level,government health expenditure and urbanization,and to explore the configuration and action path of multiple factors promoting the growth of medical insurance fund expenditure.Results:It was not comprehensive to study the growth of medical insurance fund expenditure from a single factor,because medical insurance fund expenditure worked in the form of condition configuration.Seven conditional variables formed three configuration solutions to promote fund expenditure growth,with the overall consistency of 0.96 and the overall coverage of 0.64.Conclusion:The growth of medical insurance fund expenditure is the result of the synergistic effect of various factors,and the effects of different factors in different configurations are different.We can improve the pertinency of the governance path of medical insurance fund expenditure to effectively control the excessive growth of medical insurance fund expenditure and promote the healthy operation of medical insurance fund.