About Deductible and Individual Payment Proportion Comparison Analysis of Health Insurance in Community Health Service Institutions of the Key Contact Cities
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OBJECTIVE To learn the situation of the basic medical insurance in community health service institutions of the key contact cities.METHODS Applying descriptive and statistical analysis methods to descript and analyze the deductible and individual payment proportion of the basic medical insurance in medical institutions and community health service institutions all over country.RESULTS Deductible of the basic medical insurance of employees was higher than it of the basic medical insurance of residents,the individual payment proportion of the basic medical insurance of employees was lower than it of the basic medical insurance of residents,deductible and the individual payment proportion of the basic medical insurance of employees in community health service institutions were lower than them in second-class and first-class medical institutions,there was no significant difference in the deductible and the individual payment proportion of the basic medical insurance among community health service institutions in China's eastern,central and western areas.CONCLUSIONS There was a big difference in the compensation level between the two kinds of the basic medical insurance in community health service institutions;Compensation may be appropriate to raise the level of medical insurance of residents.the compensation level of the basic medical insurance in community health service institutions was higher than it in second-class and first-class medical institutions,Should be based on the eastern,central and western regions of local economy to adjust the level of compensation.Keywords:
Deductible
Community Health
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Group insurance
National Health Insurance
Private insurance
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Medical insurance system plays a key role in China's social security system.In the social insurance system,medical insurance features the widest coverage and the most complex in mechanism,while China' s medical insurance system itself is found with many setbacks.This paper probed into such risks found in the county-level medical insurance system as excessive cost growth causing overpayment of the medical insurance fund and poor supervision of the fund.On such basis,the authors recommended such policy changes as payment reform,and enhanced supervision over the fund,the demand side,and the government,in an effort to optimize China' s medical insurance system for theoretical and decision reference of other county-level hospitals in their reforms.
Key words:
County-level hospital; Medical insurance; Risk
Medical insurance
Social insurance
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The demand for private health insurance in the UK has risen rapidly in the last decade. The paper discusses the nature of the demand for private health insurance in a health care market dominated by a public supplier, in which the consumer may neither opt out of his contribution to the National Health Service nor lose his entitlement to a free-at-any-point-of-delivery publically provided medical care. The demand for private health cover is estimated using data from the 1983 General Household Survey. The results indicate that income, the health and the medical services utilisation of adult members of households are significant determinants of the probability of purchase of health insurance cover. The results also suggest that we lack information on the nature of decision to take out and give up health insurance cover. The paper outlines research currently underway to collect and analyse data about health insurance purchase from a national representative sample of households.
Entitlement (fair division)
Sample (material)
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Since the introduction of mandatory health insurance in In, the Korean national health insurance(KNHI) has grown rapidly. In 2004, about $96.9\%$ of the total population are covered by the KNHI and the remaining $3.1\%$ by the Medical Aid program. Despite national health insurance system in Korea, private health insurance market has grown rapidly. In 2004, the size of the private health insurance market was estimated at 6,568 billion won. The purpose of this study Is to identify the factors that determine the purchasing decisions of supplementary private health insurance under mandatory national health insurance system in Korea. The data from n04 Busan Health Survey were analysed for the Purpose. The variables in this study are demographic factors, health status and health behavioral factors, health care systemic factors, and socioeconomic factors. For statistical analyse, we used logistic regression. The Findings show that female, economically active age group(especially 35-49 years), persons with better health status or experience of health screening test are more likely to purchase private health insurance. And higher household income and expenditure, higher education level are more associated with the increased probabilities of private health insurance purchases. This results imply that the expanding of private health insurance market could widen the gap between the have and have-not in terms of equal health care accessibility.
Group insurance
Medical underwriting
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This article gives an insight to the current health insurance system in the Republic of Macedonia. Specialemphasis is given to the specificities and practice of both obligatory and voluntary health insurance, to thescope of the insured persons and their benefits and obligations, the way of calculating and payment of thecontributions and the other sources of revenues for health insurance, user participation in health careexpenses, payment to the health care providers and some other aspects of realization of health insurance inpractice. According to the Health Insurance Law, which was adopted in March 2000, a person can become aninsured to the Health Insurance Fund on various modalities. More than 90% of the citizens are eligible to theobligatory health insurance, which provides a broad scope of basic health care benefits. Till end of 2008payroll contributions were equal to 9.2%, and from January 1st, 2009 are equal to 7.5% of gross earned wagesand almost 60% of health sector revenues are derived from them. Within the autonomy and scope of activitiesof the Health Insurance Fund the structures of the revenues and expenditures are presented. Health financingand reform of the payment to health care providers are of high importance within the ongoing health carereform in Macedonia. It is expected that the newly introduced methods of payments at the primary health carelevel (capitation) and at the hospital sector (global budgeting, DRGs) will lead to increased equity, efficiencyand quality of health care in hospitals and overall system.
Health reform
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Endogeneity
Instrumental variable
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Objectives To analysis the situation of the modes of the medical insurance payment of mental health institutions,and to provide the empirical basis for the formulation of relevant policies.Methods Investigating nine mental health institutions of three provinces in China by typical sampling method.Collecting relevant data of medical insurance of the hospitals and conducting in-depth interviews with the hospital managers,staves of department of medical insurance and doctors and nurses.Results The modes of payment of the major medical insurance included fee for service,global budget,the per-diem payment,capitation and etc.Different payment modes had its own advantages and disadvantages.Conclusions Medical insurance payment should be transformed from a single way to the compound mode,and the global budget standards based on the features of mental health institutions should be established scientifically and reasonably.
Mode (computer interface)
Payment system
Medical insurance
Fee-for-service
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China Mainland's national medical insurance is different from Taiwan's national health insurance in the aspect of reflecting system's welfare such as system covering,the scope and extent of the fund payment,achieving efficiency and effects of the fund etc.This is due to the difference of economic strength,concept of health insurance,health insurance management experiences and political environment between them.Learning from the experiences of Taiwan,the Mainland,who wish to enhance the welfare effects of universal medical insurance,should develop the medical insurance into a unified national health insurance;accelerate the development of private medical institutions,increase pointed medical institutions and let people see doctors unrestrained;establish a patient-centered hospital quality evaluation mechanism to guide hospitals to improve service facilities and increase service quality;speed up the fund payment pace according to service quality and diseases,accelerate to implement the total budget;reduce not building investment to the public hospitals and increase investment to people's medical insurance.
Investment
Business interruption insurance
Group insurance
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In the basic medical and health system,the scope of the basic medical and health services is determined according to basic medical insurance,medical insurance payment is determined according to the amount of basic medical and health service demand of residents,The high income earners than the low income earners enjoy higher medical insurance,basic medical service to the greater demand,but also more medical insurance subsidies.With the increase of government expenditure on health and healthcare expenditure proportion,fairness of medical service is decreased.
Scope (computer science)
Equity
Medical insurance
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Background: India is way behind many developing countries such as China, Sri Lanka, and Vietnam in terms of some health indicators and health insurance utilization. Aim: The study aimed to evaluate: (1) the source of health insurance in India, (2) the awareness of health insurance in India, and (3) to measure the satisfaction level of investors on health insurance provider. Methodology: Primary data were collected through the questionnaire among 102 general population of Maharashtra. Results: Ninety-seven percent are aware of health insurance and also have a policy. About 47.1% have all the family members covered under the health insurance, whereas 8.5% said that only the head of the family is covered. About 79.4% of the consumers were satisfied with the service provided by their health insurance provider. In the private sector, Apollo Munich and ICICI Lombard are among the ones which were preferred by the people. Sources of awareness of health insurance include employer, the Internet, newspaper, friends, and television. Conclusion: It is concluded that there is a need to create awareness among people for health insurance. Health insurance investment should not look at contingency, but it must be a regular habit. Nearly 79.4% of consumers of our sample are satisfied with the current service provider of health insurance.
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