Research On Medical Insurance Policies Against Serious Illness Among Urban And Rural Residents In Shanghai Based On Micro-Simulation
0
Citation
8
Reference
10
Related Paper
Abstract:
Abstract Background: Urban and rural residents’ basic medical insurance (URRBMI) is an institutional arrangement for rural residents and unemployed urban residents in China. The serious illness medical insurance system (SIMIS) was established to provide additional medical cover. There are two ways in which medical expenses are covered. One is based on large expenses and provides proportional compensation for the individual’s own expenses after the URRBMI payment; the other is to pay for the treatment of some serious diseases after the URRBMI payment. At present, the SIMIS payment method in China is based on large expenses, and only a few areas, such as Shanghai, pay according to the treatment of serious diseases. This study aims to simulate and analyse the effect of the two payment methods on SIMIS in Shanghai. Methods: We developed a micro-simulation model to predict the number and characteristics of SIMIS participants among urban and rural residents in Shanghai and to simulate the process of medical treatment, medical consumption, and medical insurance payments for each insured person from 2020 to 2025. We then summarised and analysed the payment compensation effect, and compared it with Shanghai’s current policies. Results: Under the current financing standard, the payment of SIMIS according to high expenses is not sustainable and the compensation is insufficient and cannot effectively prevent or alleviate poverty. Conclusions: The policy of designing SIMIS according to national guidelines does not meet the development needs of Shanghai. Shanghai should take the current policy of paying compensation according to the treatment of serious illness as the policy basis, consider the security needs of patients with large medical expenses outside the scope of protection, and adjust policies appropriately to prevent poverty caused by illness.Keywords:
Medical expenses
Medical insurance
Medical expenses
Affect
Medical insurance
Medical care
Public health insurance
National Health Insurance
Cite
Citations (3)
Objective To compare the hospital expenses of patients with acute simple appendicitis under different medical insurance systems and to explore the influential factors for controlling the increase of the expense.Methods The case information of acute simple appendicitis hospitalized in our hospital from January 2006 to December 2011 were collected.The hospital expenses were analyzed by descriptive analysis,one-way ANOVA analysis and linear regression analysis.Results Drug expenditure accounted for the biggest proportion of 36.16%in hospital costs.The average cost and the average expenses for medicine were the highest in medical insurance for urban workers,4 970.07 yuan and 2 586.33 yuan,respectively.The daily cost of 597.62 yuan for new rural cooperative medical insurance patients was the highest,while the costs for the patients at one's own expenses were lower.The major factors affecting the hospital expenses were hospital stay,any surgery,age and payment method.Conclusion The hospital expenses of patients under different medical systems vary a lot.To control the unreasonable increase of the hospital costs,much attention should be paid to managing the different medical insurance forms and controlling the hospital stay of patients.
Medical insurance
Medical expenses
Cite
Citations (0)
본 연구는 일개 시지역에 소재한 병원급 의료기관 2개에서 2009년 한 해 동안 교통사고로 입원진료를 받은 후 퇴원한 자동차보험 환자 중 1,583명을 대상으로 진료현황과 진료내역별 진료비, 진료비 비율의 특성을 분석하였다. 분석결과 자동차보험 입원환자는 남자가 많았고, 연령은 성인기 연령층이 많았으며, 재원일수는 4~7일이 가장 많았다. 진료현황과 진료내역별 진료비, 그리고 총진료비 중 진료내역별 진료비가 차지하는 비율은 성별, 연령, 재원일수에 따라 각각 통계적으로 유의한 차이를 보였다. 특히 진료내역별 진료비는 주로 여성의 진료비가 높았고, 60대 이상의 고연령층과 재원일수가 길수록 각 진료내역별 진료비가 높았다. 따라서 각 의료기관은 연령층에 따른 효율적 진료방안을 마련하여 재원일수의 단축을 위해 노력하고, 특히 고연령층에 대한 진료패턴 파악과 신체적 정신적 상태, 중증도 등을 고려한 적정진료를 제공함으로써 진료의 효율성을 제고해야 할 것이다. This study deals with an analysis into the details of medical treatment and expenses by items of treatment as well as the factors related to the ratio between the medical treatment and expenses for 1583 patients who were hospitalized in and discharged from 2 general hospitals located at a city under the coverage of car insurance during the year 2009. As a result, there was statistically significant difference in the details of medical treatment and expenses by items of treatment as well as their composition ratio depending on the individual characters as sex, age and the number of days staying in hospital. Each medical institution should conduct a close analysis of its patients under the car insurance program as well as the factors related to medical expenses with a view to utilize them as basic data for mapping out plans for effective operation of its organization in consideration of the characters as a medicalinstitution.
Medical expenses
Medical insurance
Medical treatment
Traffic accident
Cite
Citations (1)
Using the cluster sampling method to select more than 650 medical personnel,and carry out a questionnaire survey. And try to understand the perceive and willingness on single disease payment,and also provide basis for effectively carry out medical insurance payment system in the future. The results show that medical personnel perceive and willingness on single disease payment should be improved.
Medical insurance
Carry (investment)
Cite
Citations (0)
Objective To explore the reformation of urban basic medical insurance system by reforming the assistance methods for outpatient treatment expenses of chronic diseases in patients enjoying urban basic medical insurance.Methods The advantages and disadvantages of the reform on the assistance methods for outpatient treatment expenses of chronic diseases were analyzed by comparing their effects.Results The new assistance method better adapted to the current needs of China's urban medical insurance reform,and had won the approval of many patients with chronic diseases.Conclusion We should perform and deepen continually the reform of assistance methods,adapt to the new development of medical insurance business,and increase the work efficiencies of medical insurance management.
Medical insurance
Medical expenses
Medical treatment
Cite
Citations (1)
Tort Liability Law establishes a different range of property damages for personal injury,including general compensation,disable compensation and death compensation.General compensation includes medical expenses,care expenses,transportation costs and loss of working time fee.Disable damages compensation refers to the disability living auxiliary fees and disability compensation.Death damages compensation includes funeral expenses and death compensation.
Personal injury
Medical expenses
Workers' compensation
Medical care
Cite
Citations (0)
In view of the problems with the payment of compensation for cancellation of staff employment contracts,an analysis is made of the relationship between compensation standard and number of lay-offs.It is argued that compensation standards should be established in light of the length of time employed,the mandatory age for retirement (or lawful expiration of the employment contract),and the time for re-employment.As such,a mathematic model is established to improve the method of compensation payment.
Expiration
Expiration date
Cite
Citations (0)
Objective: This study aimed to analyze the high medical expenses of hospitalized medical insurance patients for the first ten systemic diseases.Methods: We investigated the medical expenses for the first ten systemic diseases among 10 900 hospitalized medical insurance patients of a hospital,calculated the average expenses and total payment for the treatment of each of the systemic diseases that involved 5% of the total patients,computed their percentage in the total expenses,and compared them with those of all the other hospitalized cases.Results: The medical cost of the 5% of the first 10 hospitalized systemic diseases accounted for 21%-29.9% of the total expenses of all the hospitalized patients,4.3-6.0 times that of the average expenses,and 30.8%-54.9% paid by the patients themselves.In addition,the hospital stay of these patients was 1.5-4.7 times that of the average.Conclusion: The high medical expenses involving 5% of the hospitalized patients with the first 10 systemic diseases amounted to a quarter of those paid by all the hospitalized patients.Effective measures have to be taken to keep high hospitalization expenses at a reasonable level.
Medical expenses
Medical insurance
Medical costs
Cite
Citations (0)
Based on the 2008 wave of the Chinese Longitudinal Healthy Longevity Survey(CLHLS),this paper uses nested multivariate tobit regression model to examine effect of medical insurance status on older adults' medical expenses.Results show that the aged' health condition and economic status are significantly associated with their medical expenses;in contrast,medical insurance status has not have significant effect on their medical expenses.The current medical insurance can' t meet the aged' health needs yet and their medical expenses are mainly paid by their children.The aged' medical status brings out typical shortage character.So we should try our best to expand medical insurances' coverage and values to improve the aged'ability to pay medical expenses and meet their health needs.
Medical expenses
Tobit model
Medical insurance
Economic shortage
Cite
Citations (2)
Objective To lucubrate the burden of medical expenses of chronic patients in medical insurance group,and to explore the perfect tactics of controlling medical expenses.Methods With stratified cluster random sampling,400 chronic patients were selected from the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine to undergo a survey about medical expenses burden.Results Generally speaking,chronic patients in medical insurance group felt the burden of medical expenses heavy.To a certain extent,medical insurance can compensate for medical costs.But the satisfaction of it was not high.Conclusion Medical insurance system should play a guiding role to make community-focused prevention and management of chronic diseases.
Medical expenses
Medical insurance
Medical costs
Multiple Chronic Conditions
Stratified Sampling
Medical care
Cite
Citations (0)