通讯作者: 周晓媛, zhouxyuan@scu.edu.cn

DOI：10.12201/bmr.202007.00020

Comparative analysis across UEBMI and URRBMI from input-output perspective --- Based on data from 21 overall planning regions in Sichuan Province

• 摘要：目的 关于职工医保和居民医保，一直以来对产出（结果）研究较多，而对投入以及投入-产出之间的差异研究不足。在建立和发展多层次医疗保障体系的背景下，本文从投入-产出的角度对不同基本医疗保险作对比分析，以参保人的视角探索职工医保和居民医保投入-产出存在的问题，为进一步完善多层次医疗保障体系提供参考依据。方法 运用经济学中成本（投入）-效果（产出）评价方法，采用住院实际补偿比作为产出指标，测算两类保险的绝对成本和相对成本，分析两类基本医保的投入-产出比和增量成本效果比。结果 21个统筹地区职工医保人均缴纳保费（绝对成本）是居民医保的5-12倍，职工医保缴费占比（相对成本）约为居民医保的3-7倍。居民医保的投入-产出比是职工医保的2-5倍，有两个地区的居民医保具有绝对成本-效果优势。结论 对参保人员而言，职工医保人均投入远超过居民医保；职工医保基金的投入产出效率低于居民医保；职工医保的成本-效果优势将逐渐弱化。

  关键词： 城镇职工医疗保险；城乡居民医疗保险；投入产出比；增量成本效果

   

  Abstract: Abstract: Objective Under the background of the establishment and development of multi-level medical security system, this paper makes a comparative analysis of different basic medical insurances from the input-output perspective, and explores the input-output problems of Urban Employed Basic Medical Insurance (UEBMI) and Urban-rural Residency Basic Medical Insurance (URRBMI) from the perspective of the insured, so as to provide reference basis for the further improvement of multi-level medical security system. Methods The cost (input) -effect (output) evaluation method in economics was used, the actual compensation ratio of hospitalization was used as the output index, the absolute and relative costs of the two types of insurance were measured, and the input-output ratio and incremental cost-effective ratio (ICER) of the two types of basic medical insurance were analyzed. Results The per capita premium (absolute cost) of UEBMI in 21 overall planning areas was 5-12 times that of URRBMI, and the proportion of premium of UEBMI (relative cost) was about 3-7 times that of URRBMI. The input-output ratio of URRBMI is 2-5 times that of URRBMI, and URRBMI in two regions has absolute cost-effectiveness advantage. Conclusion The per capita input of UEBMI is far more than that of URRBMI from the perspective of the insured. The input-output efficiency of UEBMI is lower than that of URRBMI. The cost-effectiveness advantage of UEBMI will gradually weaken.

  Key words: UEBMI, URRBMI, input-output ratio, ICER

  提交时间：2020-10-27

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2020-07-07	bmr.202007.00020V1	下载

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