摘要
Objective:Operational efficiency and influencing factors of China's basic medical insurance system from 2020 to 2021 is conducted to provide reference for improving the operational efficiency and optimizing the input-output relationship.Methods:The super-efficiency SBM model based on unexpected output and the Malmquist index are used to measure the static and dynamic efficiency of resident medical insurance in 31 provinces in China,and Tobit regression analysis is employed to analyze the influencing factors.Results:The overall operational efficiency of resident medical insurance still needs improvement.The operational efficiency of resident medical insurance in the central and western regions is lower than that in the eastern region,and the gap is significant.Different levels and regions have differentiated main constraints on the operational efficiency of resident medical insurance.In terms of dynamic efficiency,the total factor productivity of resident medical insurance operation shows an increasing trend,mainly due to technological progress.In terms of influencing factors,the degree of aging,the level of medical expenses and the level of medical insurance supervision have a significant impact on the operational efficiency.Suggestions:Efforts should be made to bridge regional disparities,promote the equitable development of medical insurance,reasonably control the level of medical expenses,strengthen the supervision of medical insurance funds,and implement active aging policies.
摘要
Objective:The elasticity and correlation analysis were applied to analyze the influence of medical insurance differentiation reimbursement policy to guide the flow of patients,as well as the implementation of the policy of hierarchical medical system to find the problem,and then make policy recommendations for hierarchical diagnosis and health care.Methods:Yanqing District(Beijing),Mishan and Hulin(Heilongjiang) and Longxi County(Gansu) were selected as four research sites to collect each site's New Rural Cooperative Medical System(NCMS) annual data for quantitative analysis.The sample areas' NCMS annual data (from 2013 to 2015)were collected for correlation analysis and elasticity calculation by SPSS 23.0.Results:(1) Each site patients' elasticity of income and medical service price was low,the elasticity of outpatient volume-hospital service price was high.(2) Patients' behavior of choosing medical institutions to seek medical advice had low correlation with their income level and medical service prices,which had formed stable medical habits.Conclusion:Medicare differentiated reimbursement policy had a certain effect on guiding the flow of patients,but the effect was not obvious in the county.The main obstacles to implement basic initial diagnosis were the weak capacity of grassroots medical institutions and policy support was not in place.It was suggested that the health insurance differentiation reimbursement policy should be combined with the disease restriction policy,strengthen the grassroots capacity building,establish and improve the supporting policy.