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Effects of New Rural Cooperative medical Scheme on medical service utilization and medical Expense Control of Inpatients： A 3-year Empirical Study of Hainan Province in China

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Chinese medical Journal 2016年第11期129卷 1280-1284页

作者： Tao Dai Hong-Pu Hu Xu Na Ya-Zi Li Yan-Li Wan Li-Qin Xie Center 1or Health Policy and Management institute of Medical Inlormation Chinese Academy ol Medical Sciences Beijing 100020 China

Background： The New Rural Cooperative medical Scheme （NCMS） has been further adjusted and optimized to reduce the financial burden of rural residents and to achieve universal coverage for them. In this study, we aimed to explore the impact of NCMS on medical service utilization and medical expense of inpatients in recent years. Methods： The research data of Hainan Province were extracted from the Chinese NCMS platform from 2012 to 2014. Detailed information included total expenditure, average inpatients costs, average out-of-pocket payments, actual reimbursement rate, and average annual growth rate of the above indicators. Descriptive analysis was used to gauge the effects of NCMS. Results： In the utilization of medical services, NCMS inpatients in tertiary hospital decreased from 25.49% in 2012 to 20.39% in 2014, inpatients in county hospitals increased from 39.49% to 55.92%, simultaneously. The total expenditure in county hospitals rose steadily from 28.46% to 46.66%, meanwhile, the total expenditure in tertiary hospitals fell from 60.44% to 44.51%.The average out-of-pocket costs of rural inpatients remained stable over the years. Furthermore, the compensation fund ofNCMS inpatients grew significantly. The actual inpatient reimbursement rate at township health centers increased from 76.93% to 84.04%. Meanwhile, the rate at county hospitals and tertiary hospitals increased slightly from 59.37% and 46.10% to 61.25% and 47.71%, respectively. Conclusions： With the improvement of the reimbursement ability, especially after the new health care reform in 2009, the NCMS have been playing a prominent role in alleviating the economic burden of farmers＇ medical treatment. Meanwhile, more patients go to primary hospitals than tertiary hospitals, and the capability of primary hospitals has been greatly improved.

关键词： Hainan Province medical Expense Control medical service utilization New Cooperative medical Scheme

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medical service utilisation, economic burden and health status of patients with rare diseases in China

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Journal of Chinese Pharmaceutical Sciences 2018年第5期27卷 361-369页

作者： Mengyuan Fu Xiaodong Guan Guoxu Wei Xiaoxiong Xin Luwen Shi School of Pharmaceutical Sciences Peking University Health Science Center Beijing 100191 China International Research Center for Medicinal Administration Peking University Health Science Center Beijing 100191 China

Many patients with rare diseases not only suffer from more severe conditions but often receive less disease management, which is one significant public health concern globally. Few practice-based surveys focus on the care of patients with rare diseases. In the present study, we aimed to investigate medical service utilization, economic burden and health status of patients with rare diseases in China. A cross-sectional questionnaire survey focusing on patients with rare diseases was conducted. Descriptive analysis was conducted to examine the sociodemographic characteristics, medical service utilization, economic burden and health status. Logistic regression analysis was applied to explore influencing factors of self-rated health. A total of 982 patients with 81 types of diseases were included in this survey. We found that 58.2% of patients experienced misdiagnosis, and 35.2% of the patients were misdiagnosed for at least five times. Moreover, 65.8% of patients traveled to hospitals to seek medical services, and 92.1% of patients paid expenses for their treatment. However, only 1.3% of patients could afford their medical expenditure without debts, and 86.8% of patients regarded their health status as bad or moderate. Significant factors correlated with health status were economic status, gender, age, employment and household size. From this study, the accessibility of medical service utilization, the affordability of medical economic burden, and the condition of health status for patients with rare disease in China were considerably poor. Basic medical insurance did not play its role in improving the utilization of medical services and the affordability of medical costs. Social support should be encouraged to improve patients＇ health status.

关键词： medical service utilization Economic burden Health status Rare diseases

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新生儿未参保之谜：基本事实、成因及其影响

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社会保障制度 2020年第7期

作者：赵绍阳陈钰晓何庆红

中国已基本实现全民医疗保险覆盖，基本医疗保险参保率多年维持在95％以上，剩下的未参保人群成为真正实现全民医疗保险的“最后一公里”。精准识别未参保人群对于完善当前医疗保障制度具有重要意义。本文基于中国家庭追踪调查数据(CFPS... 详细信息

中国已基本实现全民医疗保险覆盖，基本医疗保险参保率多年维持在95％以上，剩下的未参保人群成为真正实现全民医疗保险的“最后一公里”。精准识别未参保人群对于完善当前医疗保障制度具有重要意义。本文基于中国家庭追踪调查数据(CFPS)，描述了大量新生儿未参加基本医疗保险的事实，并实证分析了参保率较低的原因及其对医疗服务利用的影响。描述性统计结果显示，新生儿参保率不足1/2，大大低于其他年龄阶段人群的参保率。进一步实证分析发现，父母不了解新生儿参保政策信息、基层组织缺乏向新生儿家庭宣传参保政策的激励是新生儿参保率低的主要原因。最后，考察未参保对新生儿医疗服务利用产生的影响，发现未参保状态显著降低了新生儿的医疗服务利用率。为了提高新生儿基本医疗保险参保率，政府一方面应针对性地加强新生儿医疗保险政策宣传，降低新生儿参保的信息障碍；另一方面应积极推动新生儿自动纳入基本医疗保障范围，甚至应考虑制定专门针对新生儿的医疗保健计划。

关键词：新生儿参保医疗保险医疗服务利用信息认知 uninsured newborns medical insurance medical service utilization information friction

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