南京医科大学学报（社会科学版）2025，Vol.25Issue(2)：121-130,10.DOI:10.7655/NYDXBSSS240322
可持续性视角下我国医保基金发展规模预测研究
The prediction of the development scale of China's medical insurance fund from the perspective of sustainability
摘要
Abstract
Based on the perspective of sustainability,this paper analyzes the current revenue and expenditure of China's basic medical insurance and its constituent insurance types.Using the revenue and expenditure data of China's basic medical insurance fund from 2009 to 2022 as the prediction indicator,this study constructs a grey GM(1,1)prediction model to predict the scale and balance of China's basic medical insurance fund revenue and expenditure.From 2023 to 2030,the scale of China's basic medical insurance fund will continue to expand,but the growth rate of the fund's current balance will decline.During the"15th Five-Year Plan"period,the expansion of the medical insurance fund will decelerate,with potential structural risks.Specifically,there is a risk of age structure imbalance in urban employee medical insurance,while urban and rural resident medical insurance encounters government fiscal pressure risks caused by disproportionate welfare tendency and medical service optimization-seeking behavior.Moving forward,we should uphold the safety-net function of the medical insurance system in protecting people's livelihood,further optimize the operation mechanism of the medical insurance fund,and enhance service quality to ensure the sustainable development of the system.关键词
基本医疗保险/医保基金/可持续性视角/GM(1,1)Key words
basic medical insurance/medical insurance fund/sustainable perspective/GM(1,1)分类
经济学引用本文复制引用
丁海峰,陈希安..可持续性视角下我国医保基金发展规模预测研究[J].南京医科大学学报（社会科学版）,2025,25(2):121-130,10.基金项目
国家社会科学基金重点项目"全景关怀:大国社会保障高质量发展研究"(22FGLA004) （22FGLA004）
湖南农业大学研究生科研创新项目"数字技术对农村老人健康老龄化的影响机制研究"(2024XKC082) （2024XKC082）
