Study On Influencing Factors And Evaluation Of Sustainable Development Ability Of Urban Employees' Basic Medical Insurance Fund Based On PSR Model

[Purpose]The main purpose of this study is to further explore the influencing factors of the sustainable development of the urban employees' basic medical insurance fund,and analyze its manifestation and characteristics in detail.Then constct an evaluation model of the urban employees' basic medical insurance fund to comprehensively evaluate its the sustainable development capabilities.And find the problems existing in the operation of the fund,propose the policy recommendations for reference.[Methods]1.This paper analyzes the current status of the urban employees' basic medical insurance fund operation through descriptive statistics;2.Use literature research and panel discussions to identify factors that influence the sustainability of the fund;3.The factor analysis method is used to reduce and generalize the influencing factors,and the regular factors that can represent the influence of all factors are screened out;4.The evaluation model of the sustainable development ability of the urban employees' basic medical insurance fund is constructed by the PSR model;5.The weight of the specific indicators in the evaluation model is determined by the entropy weight method.6.The multi-objective linear weighting method is used to calculate the comprehensive evaluation value of the sustainable development ability of the national and provincial employees to the urban employees' basic medical insurance fund.[Results]1.The influencing factors were reduced to 15 indicators of five types which represent 80% of the original variables through factor analysis.These five types of variables are F1 economic factor,F2 policy factor,F3 fund factor,F4 medical factor and F5 age factor,and their corresponding contribution rates are 21.59%,19.49%,19.41%,10.47.% and 9.04%.2.This study constructed a PSR evaluation model for the sustainable development of the urban employees' basic medical insurance funds,which consists of 13 indicators in three project levels: stress,status,and response.The weights of each project layer and its corresponding specific indicators were measured,and the weights of the pressure,state and response layers were 0.447,0.281 and 0.272.3.In 2017,the top three rankings of the comprehensive evaluation of the sustainability of the urban employees' basic medical insurance funds in various provinces and cities nationwide were Beijing,Shanghai and Guangdong,which were 0.677,0.621 and 0.569 respectively.The last three places were Qinghai,Guangxi and Guizhou.0.254,0.252 and 0.206.The highest and lowest pressure evaluation values were Shanghai and Qinghai,0.250 and 0.103.The highest and lowest of the state evaluation values were Tibet and Jilin,0.218 and 0.040.The highest and lowest response evaluation values were Beijing and Guizhou,0.267 and 0.016.4.From 2002 to 2017,the comprehensive evaluation value of the sustainable development capacity of urban employees' basic medical insurance fund increased from 0.334 to 0.403,the annual average growth rate was 1.39%.The pressure evaluation value increased from 0.187 to 0.205,the annual average growth rate was 0.79%.And the state evaluation value was 0.079 in 2002 and 0.094 in 2017,with an average annual increase of 2.29%.The response evaluation value increased from 0.067 to 0.104,with an average annual increase of 3.73%.[Conclusions]1.Through the analysis of the impact mechanism of sustainable development of the urban employees' basic medical insurance funds from the fund financing factors,expenditure factors and management factors,it is concluded that influencing factors are diverse,dynamic and complex,including economic development,population change,medical technology development,disease spectrum changes,internal management of the organization and many other aspects.The results of factor analysis show that economic factors have the most significant impact on the continued development of the fund.2.The greater the weight in the evaluation model,the more important it is.The pressure layer has the highest weight,which indicates that the pressure of multiple social and economic environments is the key to affecting its sustainable development ability in the operation of the the urban employees' basic medical insurance fund.3.Judging from the ranking of the comprehensive evaluation value of the sustainable development capacity of the the urban employees' basic medical insurance fund in all provinces and cities in 2017,the regions with relatively developed economies are ranked high.It is shown that the sustainable development capacity of the urban employees' basic medical insurance fund is closely related to the level of regional economic development.According to the difference in evaluation values of each project level in each province and city,the largest difference is the response evaluation value.It shows that there are large differences in the effects of policy adjustments in various provinces and cities.Strengthening government responsibilities and timely policy adjustments or reforms have a greater impact on the sustainable development of the fund.4.From 2002 to 2017,the comprehensive evaluation value of the sustainable development capacity of the urban employees' basic medical insurance fund has been growing.The increase in pressure evaluation value is the smallest,indicating that the internal and external environment has an increasingly deep impact on the continued development of the fund.The growth rate of the response evaluation value is faster,indicating that the policy adjustment effect made by the government departments in response to the complex impact of the social and economic environment is obvious.In the next few years,the growth rate has declined.It shows that the welfare benefits brought about by the policy adjustments made by the government in the early stage have gradually failed to curb the negative impacts brought by objective factors in the socio-economic environment.The sustainable development capacity of the urban employees' basic medical insurance funds has weakened.Therefore,it is necessary to construct a long-term development of the the urban employees' basic medical insurance top-level design framework according to local conditions,and rationally reform and combine various policies.Therefore,it is necessary to construct a long-term development of the urban emloyees' basic medical insurance toplevel design framework according to local conditions,and rationally reform and combine various policies.