Health Management College, Anhui Medical University, Hefei 230032, China.
School of Marxism, Anhui Medical University, Hefei 230032, China.
Int J Environ Res Public Health. 2022 Oct 24;19(21):13831. doi: 10.3390/ijerph192113831.
Following the integration of the urban residents' medical insurance into the new rural cooperative medical insurance in 2016, China has now formed a basic medical insurance system with the urban workers' basic medical insurance system and the rural residents' basic medical insurance system as the main entities. With the development of basic medical insurance, the protection for residents is becoming more and more comprehensive, and its fund expenditure also increases, so it is necessary to research the efficiency of the medical insurance fund expenditure. This paper conducts a three-stage DEA analysis of the efficiency of basic health insurance for urban and rural residents in 31 provinces, based on a Chinese panel data from 2017 to 2020. It is found that China's health insurance operation is still in the development stage, with four regions in the efficiency frontier and Guizhou province having the lowest efficiency value nationwide. The GDP and fiscal investment on social security effectively reduce the input redundancy in the basic health insurance operation, which contributes to the efficiency of the health insurance operation. This study further proposes suggestions and countermeasures to improve the operational efficiency of China's basic health insurance, based on the empirical results: (1) develop the economy and broaden the financing sources; (2) improve the level of health care services and improve the efficiency driven by quality; and (3) improve the level of health insurance supervision through multiple measures.
2016 年城镇居民医疗保险与新型农村合作医疗保险整合后，中国已形成以城镇职工基本医疗保险制度、农村居民基本医疗保险制度为主体的基本医疗保险制度。随着基本医疗保险的发展，居民的保障越来越全面，基金支出也不断增加，因此有必要研究医疗保险基金支出的效率。本文基于 2017 年至 2020 年中国面板数据，对 31 个省、自治区、直辖市的城乡居民基本医疗保险效率进行了三阶段 DEA 分析。结果表明，中国医疗保险运营仍处于发展阶段，有四个地区处于效率前沿，而贵州省的全国效率值最低。国内生产总值和财政社会保障投资有效降低了基本医疗保险运营中的投入冗余，有助于提高医疗保险运营效率。本研究基于实证结果，进一步提出了提高中国基本医疗保险运营效率的建议和对策：（1）发展经济，拓宽融资渠道；（2）提高医疗服务水平，提高质量驱动的效率；（3）通过多种措施提高医疗保险监管水平。
