| 引用本文: |
高润国,马安宁,盛红旗.基于灰色马尔可夫模型的山东省城镇职工基本医疗保险基金收支失衡风险预测研究[J].中国卫生经济,2018,(3):31-34.[点击复制] |
.Study on risk prediction and evaluation of basic medical insurance fund for urban workers in Shandong Province Based on Grey Markov model[J].CHINESE HEALTH ECONOMICS,2018,(3):31-34.[点击复制] |
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| 摘要: |
| 目的：利用2002-2015年14年间山东省城镇职工基本医疗保险基金筹资与支付总额时间序列，预测2016-2027年的基本发展态势。方法：利用灰色Verhulst模型建立拟合模型，利用拟合结果，使用马尔可夫模型构建预测2016-2027年相对残差状态，用预测的相对残差状态来修正灰色Verhulst模型预测的结果，从而提高预测的精度。结果：利用2002年到2015年我国国内生产总值指数调整后的基金筹资与支出时间序列，符合灰色Verhulst模型，属于典型的增长函数模型，分别的拟合相对误差为2.79%和2.41%，拟合效果较好。通过马尔可夫模型修正后的基金筹资和支出相对误差分别减少为0.77%和0.73%，预测精度大幅提高。预测2025年山东省城镇职工基本医疗保险基金筹资和支出为748.73亿元和827.34亿元。结论：如果山东省城镇职工基本医疗保险保持现有的筹资支付政策不变，在2020年左右出现年度超支风险，加上历史年度累计结余，超支风险会后延到2025年以后。建议适当提高城镇职工基本医疗保险统筹层次，由地市级统筹逐步提高到省级统筹，增强基金防范风险的能力。改变现有的基金支付方式，防范逆向选择和道德风险发生的可能性。 |
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| Study on risk prediction and evaluation of basic medical insurance fund for urban workers in Shandong Province Based on Grey Markov model |
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| Abstract: |
| Objective: From 1995 to 2015, the time series of funds and payments of basic medical insurance fund for urban workers in China was predicted from 2016 to 2025, and the basic development of was compared. Methods: Using the fitting time series ARIMA model to build the urban workers’’’’’’’’ basic medical insurance fund financing and payment of the total relative residual state to construct the annual use of Markov model to the fitting results, the state matrix to predict 2016 to 2025 relative residual state, to modify the time series prediction results. Results: the simulated time series of financing only, the relative fitting error is 5.81%, the relative error of the Markov model after correction for 2.01%; ARIMA simulation of spending time series, the relative fitting error is 9.14%, the relative error of the modified Markov model is reduced to 5.35%. In 2025, the basic medical insurance fund for urban employees in China was raised to 2 trillion and 301 billion 596 million yuan and 1 trillion and 909 billion 82 million yuan. There will be no annual overspending from 2016 to 2025. Conclusion: the basic medical insurance for urban employees will remain unchanged throughout the country, and the current funding policy will remain unchanged, and there will be no overruns during 2016 to 2025. It is suggested that the overall level of basic medical insurance for urban workers should be improved, and the overall level of the basic medical insurance for urban workers should be gradually raised to the provincial level as a whole, so as to improve the ability of the fund to prevent risks. |
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