基于GM(1,1)模型的山西省城乡居民个人医疗负担预测

Prediction of Individual Medical Burden of Urban and Rural Residents in Shanxi Province Based on GM(1,1) Model

摘要: 目的：对山西省城乡居民个人卫生费用支出医疗经济负担变化趋势进行评价，为卫生部门制定和调整医疗卫生政策提供合理参考。方法：运用GM(1,1)模型对2018年~2022年的山西省城乡居民个人卫生费用支出及其占卫生总费用的比例进行预测。结果：经预测，2018年~2022年，山西省城乡居民个人卫生费用支出占卫生总费用的比例将会呈现继续下降的态势，将会由30.52%降低至27.10%，下降了3.42%，平均每年下降0.86%，说明山西省城乡居民个人卫生费用支出的医疗经济负担将逐步减轻，“因病致贫，因病返贫”风险发生的概率将会逐步减小，其卫生筹资结构公平性将进一步得到优化。结论：建议政府科学增加财政投入，调整政府卫生支出内部结构；积极支持社会卫生支出，合理提高社会医疗保险报销比例；积极支持商业健康保险的发展。

Abstract: Objective: To evaluate the changing trend of the medical economic burden of personal health expenditures of urban and rural residents in Shanxi Province, to provide a reasonable reference for the health department to formulate and adjust medical and health policies. Methods: The GM(1,1) model was used to predict the personal health expenditures of urban and rural residents in Shanxi Province from 2018 to 2022 and their proportion in total health expenditures. Results: It is predicted that from 2018 to 2022, the proportion of personal health expenditures of urban and rural residents in Shanxi Province in total health expenditures will continue to decline, which will drop from 30.52% to 27.10%, a decrease of 3.42%. The annual decrease of 0.86% indicates that the medical economic burden of personal health expenditures for urban and rural residents in Shanxi Province will gradually be reduced, the probability of “poverty due to illness and return to poverty due to illness” will gradually decrease, and the fairness of its health financing structure will be further improved Get optimized. Conclusion: It is recommended that the government scientifically increase financial investment and adjust the internal structure of government health expenditures; actively support social health expenditures and reasonably increase the proportion of social medical insurance reimbursement; actively support the development of commercial health insurance.