Abstract: As the population ageing process accelerates, the sustainability of China's health system faces increasingly significant challenges. Therefore, exploring the impact of population ageing on health expenditure is of great importance. Based on data from hospital admission records in Beijing and the China Family Panel Studies (CFPS) data, the Das Gupta decomposition method is adopted to analyze the contribution of population ageing to the growth of health expenditure. The analysis of hospital admission records from 2016 to 2019 reveals that the change in the age structure contributed 22.44% to the growth of hospitalization expenses. CFPS estimates show similar national results. The impact of population ageing on health expenditure is more pronounced among the elderly, with age structure changes accounting for 24.24%, 37.47%, and 31.51% of the variations of hospitalization expense for patients aged 50-64, 65-79, and 80 years old and above, respectively. Improving healthcare financing, promoting healthy ageing, and enhancing system efficiency are recommended.

Keywords: Population Ageing, Health Expenditure, Healthcare Security, Age Structure Changes, Contribution Decomposition

摘要： 随着人口老龄化进程加快，中国医疗保障体系的可持续性面临日益增大的挑战，因此探究人口老龄化对医疗费用变动的影响具有重要意义。基于北京市住院病案首页数据和中国家庭追踪调查(CFPS)数据，利用Das Gupta提出的多维因素分解法分析发现，在2016~2019年的北京市住院费用增长中，患者年龄结构变化的贡献率为22.44%；相近时期内，全国人口年龄结构变化对住院费用和就医总费用增长的贡献率与北京市的结果相近；人口老龄化对医疗费用增长的影响在老年群体中更为明显，在50~64岁、65~79岁和80岁及以上患者住院费用的增长中，分别有24.24%、37.47%和31.51%由人群内部年龄结构老化造成。建议完善与人口老龄化进程相适应的医疗保障筹资机制，采取多种措施促进健康老龄化，提高医疗保障资金的利用效率，从而提升医疗保障体系的可持续性。

关键词: 人口老龄化, 医疗费用, 医疗保障, 年龄结构变动, 贡献分解