基于DEA的河南省新农合基金运行效率研究

发布时间：2018-05-26 08:06

本文选题：新型农村合作医疗 + 基金　；参考：《海南大学》2017年硕士论文

【摘要】：新型农村合作医疗(简称新农合)是我国现行的农村基本医疗保障制度,与城镇居民基本医疗保险、城镇职工基本医疗保险共同构成社会基本医疗保险体系。自2009年"新医改"方案出台到2015年年末,河南省新农合的发展呈现良好的上升态势,参合人数达8285.06万人,参合率达99.12%。新农合基金是为实现新农合制度目标服务的、根据新农合制度的相关政策筹集起来的资金。新农合基金的筹集、统筹管理和补偿是新农合制度执行中的重要内容,是新农合顺利实施、平稳运行的根本保证。分析评价河南省不同地区新农合基金运行效率的差异,找出产生低效率的原因,能够进一步完善新农合制度。本文对河南省新农合的实施现状进行了筹资、统筹管理和补偿三个方面的介绍,分析了河南省新农合基金运行中存在的问题。然后通过基金和效率评价的相关理论,确定运用前沿分析方法的非参数法,即数据包络分析方法中的规模报酬可变模型和全要素生产率指数模型,以输出为导向,选取河南省24个样本县2013年到2015年的新农合基金数据进行效率分析,并针对分析结果和存在的问题提出了提高新农合基金运行效率的建设性意见。本文的研究结论有:首先,河南省的新农合基金运行效率良好。每年的技术效率平均值均在75%以上并逐年递增。北部的新农合基金运行效率总体上要优于中部和南部,中部地区的技术效率增长最快,南部地区的效率虽然在三年间有所改善,但是仍不及北部地区。其次,河南省南部地区的低技术效率主要归因于偏低的纯技术效率,即在等量投入的情况下产出相对不理想,使筹集的资金不能充分发挥作用。而且规模报酬整体处于递减的状态,说明规模过大。反观中部地区的规模报酬整体是递增的状态,暗示了这些样本县应增大新型农村合作医疗基金的规模。再次,河南省2013年到2015年无效地区的规模报酬变化递增数量逐年减少,规模报酬变化递减数量逐年增加,由整体递增变为整体递减,表明河南省新农合基金规模一直在增加,但基金运行缺乏一个相对有效的模式,需要加以改善,达到规模最优。最后,投入金额的多少与技术效率的高低并不成正比关系,如中部地区新密市(DMU11)基金投入金额最多,但是它在2013年的技术效率0.581,2014年为0.766,2015年为0.856,虽逐年上升,但得分不是最高。而滑县(DMU5)的投入金额在样本县中处于中低层次,却能够实现基金的高效运行。
[Abstract]:The New Rural Cooperative Medical system (NCMS) is the current rural basic medical insurance system in China, which, together with the basic medical insurance for urban residents and urban workers, constitutes the basic social medical insurance system. Since the "new medical reform" program was introduced in 2009 to the end of 2015, the development of the new rural cooperation in Henan Province showed a good rising trend, the number of participants reached 82.8506 million, the participation rate reached 99.12. The new rural cooperative fund serves to realize the goal of the new rural cooperation system and raises funds according to the relevant policies of the new rural cooperation system. The raising, the overall management and the compensation of the new rural cooperative fund are the important contents in the implementation of the new rural cooperation system, and the fundamental guarantee for the smooth implementation and smooth operation of the new rural cooperative fund. This paper analyzes and evaluates the differences in the operating efficiency of NCMS funds in different regions of Henan Province, finds out the causes of low efficiency, and can further improve the NCMS system. This paper introduces the current situation of the implementation of NCMS in Henan Province from the aspects of financing, overall management and compensation, and analyzes the problems existing in the operation of NRCF in Henan Province. Then, through the relevant theories of fund and efficiency evaluation, the non-parametric method using frontier analysis method, namely the variable scale reward model and the total factor productivity index model in the data envelopment analysis method, is determined to be output oriented. This paper selects 24 sample counties of Henan Province from 2013 to 2015 to analyze the efficiency of the new rural cooperative fund, and puts forward some constructive suggestions to improve the efficiency of the new rural cooperative fund in view of the analysis results and the existing problems. The conclusions of this paper are as follows: first of all, the new agricultural cooperative fund in Henan Province has a good operating efficiency. The average technical efficiency of each year is above 75% and increasing year by year. The efficiency of the NCMS fund in the north is better than that in the central and southern regions in general. The technical efficiency in the central region has the fastest growth, and the efficiency in the southern region has improved in three years, but it is still not as good as the northern region. Secondly, the low technical efficiency in the southern region of Henan Province is mainly attributed to the low pure technical efficiency, that is, the output is relatively unsatisfactory under the condition of equal input, which makes the funds raised can not play a full role. And scale reward is in the state of decline as a whole, indicating that the scale is too large. On the contrary, the scale reward of the central region is increasing, suggesting that these sample counties should increase the scale of the new rural cooperative medical fund. Thirdly, from 2013 to 2015, the number of scale returns in invalid areas of Henan Province decreased year by year, the number of scale returns decreased year by year, from the overall increase into the overall decline, indicating that the scale of Henan New Rural Cooperation Fund has been increasing. However, fund operation lacks a relatively effective model, which needs to be improved to achieve optimal scale. Finally, the amount of investment is not proportional to the level of technical efficiency, such as in the central region of Xinmi City, DMU 11) the largest amount of investment, but its technical efficiency in 2013, 2014 is 0.766, 2015 is 0.856, although rising year by year, but not the highest score. The investment amount of MU 5 is in the middle and low level in the sample county, but it can realize the efficient operation of the fund.
【学位授予单位】：海南大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：F224;F323.89;F842.684;R197.1

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