Objective To understand the financial balance of Shanghai Urban Employees' Basic Medical Insurance Pooling Fund in the future. Methods System dynamics simulation analysis was applied. Results The financial balance of Shanghai Urban Employees' Basic Medical Insurance Pooling Fund is affected by the structure of insured staff in Shanghai changing with aging and policy change. The accumulated financial balance of the pooling fund shows a steady growth trend in the short and medium term,but when the migrant employees begin to enjoy the retirement medical insurance treatment after 2029,the financial balance of the pooling fund is expected to decrease several years later,and deficits may occur. Conclusion It is suggested to establish the fund financial operation system combining the "Pay As You Go" system and the accumulation system. It is also proposed to attach importance to the control of the pooling fund expenditure growth and pay attention to the management of preserving and increasing value of the medical insurance fund.%目的 了解上海市城镇职工基本医疗保险统筹基金结余未来的财务运行情况.方法 运用系统动力学进行仿真分析.结果 上海市城镇职工基本医疗保险统筹基金结余财务运行情况受老龄化和政策变迁带来的参保职工结构变化的影响.医疗保险统筹基金累计结余中短期呈稳定增长趋势,但2029年外来从业人员开始享受退休职工医疗保险待遇后,医疗保险统筹基金累计结余长期可能出现赤字.结论 建议建立现收现付制与积累制结合的财务运行制度,重视统筹基金支出控制,重视统筹基金结余保值增值管理.
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