Research On The Early Warning Model Of Tianjin Urban Workers Basic Medical Insurance Fund's Income And Expenditure

Urban workers basic medical insurance is an important part of the basic medical insurance system in our country.The balanced operation of urban workers basic medical insurance is related to the rationality and continuity of the basic medical insurance system.In recent years,with the rapid growth of medical costs,the accelerating trend of population aging,the adjustment lag of medical insurance policy,unreasonable settlement and the changes of disease spectrum,Tianjin urban workers basic medical insurance fund's income and expenditure became unbalanced.Therefore,it is necessary to analysis the factors affecting Tianjin urban workers basic medical insurance fund balance,forecast the income and expenditure of the basic medical insurance fund for urban workers in Tianjin,carry out the early warning work of Tianjin urban workers basic medical insurance fund's income and expenditure based on the forecast.This paper talked about the collection,allocation and payment policy of Tianjin urban workers basic medical insurance fundanalysised the operation status from the insurance personnel,medical insurance fund's income and expenditure,the door(emergency)medical expenses and hospital medical expenses,explored the influence factors,so that we can understand the current operation state of it.At the same time,we used the grey prediction GM(1,1)model to forecast the 2016-2020 of Tianjin city urban workers basic medical insurance fund's income and expenditure based on the data of 2011-2015.Then we designed the early warning model based on the forecast,so that we could construct Tianjin urban workers basic medical insurance fund early warning system.The research results showed that accumulated balance of 2011-2016 Tianjin urban workers basic medical insurance fund is too little,warning degree is heavy;the accumulated balance of 2017-2020 Tianjin urban workers basic medical insurance fund is a little,warning degree is light,the opertaion is good.But in the past 5 years Tianjin urban workers basic medical insurance fund still existed the risk of income and expenditure.Therefore,Tianjin needs to follow the spirit of "open source,throttle,optimal allocation" and take measures as soon as possible to achieve the basic medical insurance fund's income and expenditure balance.