scholarly journals Analysis of Economic Effect and Mechanism of Basic Medical Insurance for Urban Employees in China

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yi Li ◽  
Xia Zhang ◽  
Xia Yang
Keyword(s):  
New Technologies ◽  
Economic Effect ◽  
Sample Selection ◽  
Medical Insurance ◽  
Nutrition Survey ◽  
Medical Expenses ◽  
Health And Nutrition ◽  
Basic Medical Insurance ◽  
New Diagnosis ◽  
Basic Medical

The purpose of social basic medical insurance is to solve the problem that “medical treatment is difficult and expensive.” With the implementation of new technologies and new diagnosis and treatment methods, the price of medicine has risen sharply. Under this background, can basic medical insurance still relieve the economic pressure of patients? Based on the tracking data of China Health and Nutrition Survey (CHNS) from 2006 to 2015, by constructing Heckman sample selection model, the paper finds that the basic medical insurance for urban employees (UEBMI) leads to an increase in medical expenses, among which only 0.61% can be attributed to the release of normal medical demand and 114.47% can be attributed to moral hazard; for flexible employees, 249.52% increase can be attributed to adverse selection. Based on this, the paper puts forward two suggestions: first, promoting Hierarchical Treatment Model to control the growth of medical expenses and second, guiding flexible employees to participate in the UEBMI.

scholarly journals A 15-Year Trend of Catastrophic Health Payment and its Inequality in China: Evidence from Longitudinal Data

2021 ◽  
Author(s):  
Yongjian Xu ◽  
Yiting Zhou ◽  
Andi Pramono
Keyword(s):  
Health Care ◽  
Decomposition Analysis ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
Chinese Government ◽  
Nutrition Survey ◽  
Basic Medical Insurance ◽  
Poor Households ◽  
Health Payment ◽  
Basic Medical

Abstract Background：The Chinese health care system has gone through two major cycles of reform since the 1980s. This study aims to comprehensively track the trends in the occurrence of catastrophic health payment and its inequality in the past 15 years, which may help better understand the influence of health system reforms on catastrophic health payment and its inequality. Methods：The study employed the subset of data from China Health and Nutrition Survey conducted from 1991 to 2015. Concentration index and decomposition analysis were used to measure the magnitude of income-related inequality in catastrophic health payment and decompose it into determinants respectively. Results: The incidence of catastrophic health expenditure in China increased from 3.10% in 1993 to 8.90% in 2004, and still maintained at a high level in the following years. The incidence gap of catastrophic health payment between the richest and poorest became increasingly wider over year. Moreover, the adjusted concentration indexes were all negative in each year, decreasing from -0.202 in 1991 to -0.613 in 2015. The basic medical insurance didn’t decrease the incidence of catastrophic health payment and showed the second largest contribution on the inequality in catastrophic health payment before 2004. However, this contribution began to decline after 2006. Conclusions: After the New Health Care Reform, although the Chinese government has taken many measures to protect poor households from catastrophic health payment, the incidence gap between the rich and poor has widened. China has nearly achieved universal coverage in recent years, however, the basic medical insurance in China was not enough to protect households from catastrophic health payment. Our study suggests that improving the generosity of existing basic medical insurance, and reforming the medical insurance payment system would be helpful to reduce the incidence of catastrophic health payment. The use of big data tools and techniques to effectively screen the poor households, and strengthening the social medical aid system would be helpful to decrease the pro-rich inequality in catastrophic health payment.

scholarly journals Patients’ preferences for health insurance coverage of new technologies for treating chronic diseases in China: a discrete choice experiment

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038051
Author(s):  
Jinsong Geng ◽  
Xiaowei Chen ◽  
Haini Bao ◽  
Danmin Qian ◽  
Yuting Shao ◽  
...  
Keyword(s):  
Health Insurance ◽  
Chronic Diseases ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
New Technologies ◽  
Insurance Coverage ◽  
Medical Insurance ◽  
Basic Medical Insurance ◽  
Basic Medical

ObjectivesOur study aimed to inform insurance decision-making in China by investigating patients’ preferences for insurance coverage of new technologies for treating chronic diseases.DesignWe identified six attributes of new medical technologies for treating chronic diseases and used Bayesian-efficient design to generate choice sets for a discrete choice experiment (DCE). After conducting the DCE, we analysed the data by mixed logit regression to examine patient-reported preferences for each attribute.SettingThe DCE was conducted with patients in six tertiary hospitals from four cities in Jiangsu province.ParticipantsPatients aged 18 years or older with a history of diabetes or hypertension and taking medications regularly for more than 1 year were recruited (n=408).ResultsThe technology attributes regarding expected gains in health outcomes from the treatment, high likelihood of effective treatment and low incidence of serious adverse events were significant, positive predictors of choice by the study patients (p<0.01). The out-of-pocket cost was a significant, negative attribute for the entire study sample (β = −0.258, p<0.01) and for the patients with Urban-Rural Residents Basic Medical Insurance (URRBMI) (β = −0.511, p<0.01), but not for all the patients with Urban Employees Basic Medical Insurance (UEBMI) (β = −0.071, p>0.05). The severity of target disease was valued by patients with lower EQ-5D-5L index value as well as URRBMI enrollees.ConclusionsPatients highly valued the health benefits and risks of new technologies, which were closely linked to their feelings of disease and perceptions of health-related quality of life. However, there existed heterogeneity in preferences between URRBMI and UEBMI patients. Further efforts should be made to reduce the gap between insurance schemes and make safe and cost-effective new technologies as a priority for health insurance reimbursement.

scholarly journals The Effect of Health Shock and Basic Medical Insurance on Family Educational Investment for Children in China

2021 ◽  
Vol 18 (10) ◽  
pp. 5242
Author(s):  
Pu Liao ◽  
Zhihong Dou ◽  
Xingxing Guo
Keyword(s):  
Negative Impact ◽  
Medical Insurance ◽  
Generation Model ◽  
Two Phase ◽  
Parental Health ◽  
Health Shock ◽  
Basic Medical Insurance ◽  
Child Education ◽  
The Impact ◽  
Basic Medical

This paper explores the role of basic medical insurance in protecting family investment in child education. First, this paper establishes a two-phase overlapping generation model to theoretically analyse the impact of basic medical insurance on investment in child education under the influence of the impact of parental health. The results show that health shock reduces parental investment in child education, and medical insurance significantly alleviates the negative impact of parental health shock on investment in child education. Furthermore, this paper establishes a two-way fixed effect regression model based on the data of China Family Panel Studies (CFPS) in 2014 and 2016 to empirically test the above results. The results showed that parental health shocks negatively affect investment in child education, and paternal health shock has a more significant impact than maternal health shock. However, medical insurance significantly reduces this negative impact, provides security in investment in child education, and promotes the improvement of human capital.

scholarly journals Comorbidity in lung cancer patients and its association with hospital readmission and fatality in China

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dawei Zhu ◽  
Ruoxi Ding ◽  
Yong Ma ◽  
Zhishui Chen ◽  
Xuefeng Shi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Hospital Readmission ◽  
Medical Insurance ◽  
Hospital Death ◽  
Comorbid Condition ◽  
Lung Cancer Patients ◽  
Basic Medical Insurance ◽  
Increased Risk ◽  
Basic Medical

Abstract Background Comorbidity has been established as one of the important predictors of poor prognosis in lung cancer. In this study, we analyzed the prevalence of main comorbidities and its association with hospital readmission and fatality for lung cancer patients in China. Methods The analyses are based on China Urban Employees’ Basic Medical insurance (UEBMI) and Urban Residents’ Basic Medical Insurance (URBMI) claims database and Hospital Information System (HIS) Database in the Beijing University Cancer Hospital in 2013–2016. We use Elixhauser Comorbidity Index to identify main types of comorbidities. Results Among 10,175 lung cancer patients, 32.2% had at least one comorbid condition, and the proportion of patients with one, two, and three or more comorbidities was 21.7, 8.3 and 2.2%, respectively. The most prevalent comorbidities identified were other malignancy (7.5%), hypertension (5.4%), pulmonary disease (3.7%), diabetes mellitus (2.5%), cardiovascular disease (2.4%) and liver disease (2.3%). The predicted probability of having comorbidity and the predicted number of comorbidities was higher for middle elderly age groups, and then decreased among patients older than 85 years. Comorbidity was positively associated with increased risk of 31-days readmission and in-hospital death. Conclusion Our study is the first to provide an overview of comorbidity among lung cancer patients in China, underlines the necessity of incorporating comorbidity in the design of screening, treatment and management of lung cancer patients in China.

scholarly journals The influence of medical insurance and social security cards on the floating population's settlement intention

2020 ◽  
Author(s):  
Yulin Li ◽  
Lingling Huang ◽  
Li Xiang ◽  
dongmei dou
Keyword(s):  
Social Security ◽  
Social Integration ◽  
Indirect Effect ◽  
Structural Equation ◽  
Medical Insurance ◽  
Floating Population ◽  
Dynamic Monitoring ◽  
Basic Medical Insurance ◽  
The Government ◽  
Basic Medical

Abstract Background There are many studies on the influencing factors of floating population's intention to settle down. Medical insurance and social security cards have an important guarantee for the floating population to live a stable life in the current residence, but there are limited studies focused on the influence of medical insurance and social security cards on their settlement intention. Therefore, the purpose of this paper is to study the influence of medical insurance and social security card on the settlement intention of floating population, so as to create better living and working conditions for floating population and improve their happiness in their current place of residence. Methods Based on the survey data of China's floating population dynamic monitoring in 2017, we explored the influence of medical insurance (urban employee basic medical insurance) and social security cards on the floating population's settlement intention with binary logistic regression and structural equation model. Additionally, this study was also to examine the comprehensive causal relationship, with social integration as the mediator variable. Results The floating population's settlement intention on participating in urban employee basic medical insurance is 23.2 percent higher than those who did not participate. Whether to apply for personal social security cards is related to the settlement intention. The standardized regression coefficients among social insurance and security, social integration, and settlement intention are positive values, and the Z values ​​of the overall effect, indirect effect, and direct effect are all greater than 1.96, and the confidence interval of the indirect effect does not include 0. The article found that this model is a partial intermediary, with an intermediary ratio of 10.66 percent. Conclusions The article highlights the important impact of urban workers' medical insurance and individual social security cards on the floating population. The results of this study may provide some reference for the government to formulate relevant policies.

scholarly journals Inequity under Equality: Research on the Benefits Equity of Chinese Basic Medical Insurance

2020 ◽  
Author(s):  
Li Diao ◽  
Yiwei Liu
Keyword(s):  
Health Care ◽  
Low Income ◽  
Choice Model ◽  
Empirical Test ◽  
Medical Insurance ◽  
High Income ◽  
Mechanism Analysis ◽  
Basic Medical Insurance ◽  
Income Groups ◽  
Basic Medical

Abstract Background: The pursuit of equity is one of the basic principles behind the strengthening of health care reform. China's new rural cooperative medical insurance (NRCMI) and urban residents' basic medical insurance (URBMI) are both “equalized” in terms of fundraising and reimbursement. This paper studies the benefits equity under this "equalized" system.Methods: The data analysed in this paper are from the China Family Panel Studies (CFPS) from 2014 to 2016, implemented by the Institute of Social Science Survey at Peking University. A two-part model and a binary choice model are used in the empirical test.Results: The empirical test revealed that high-income people benefit more from basic medical insurance than low-income people. Mechanism analysis demonstrated that high-income people have higher medical insurance applicability and can utilize better health care. Since low-income people are unhealthier, inequity in benefits exacerbates health inequity. We also found that the benefits equity of URBMI is better than that of NRCMI.Conclusions: The government needs to pay more attention to the issue of medical insurance inequity. We should consider allowing different income groups to pay different premiums according to their medical expenses or applying different reimbursement policies for different income groups.

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