scholarly journals Research On Medical Insurance Policies Against Serious Illness Among Urban And Rural Residents In Shanghai Based On Micro-Simulation

2021 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Institutional Arrangement ◽  
Medical Insurance ◽  
National Guidelines ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Urban And Rural Residents ◽  
Micro Simulation ◽  
Insured Person ◽  
Basic Medical

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.

scholarly journals Analysis of the Effect of Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China: A Case Study in Jinzhai County

2020 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Medical Insurance ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Out Of Pocket Expenses ◽  
Annual Average Number ◽  
Technology Level

Abstract Background: In 2003, China established a New Rural Cooperative Medical System (NRCMS) for rural residents to alleviate the burden of medical expenses among rural residents. However, its reimbursement for high medical costs was insufficient. Therefore, China gradually established the Serious Illness Insurance System (SIMIS) based on NRCMS. After receiving payment through NRCMS, patients in rural areas who met the requirements of SIMIS policy would receive a second payment for their high medical expenses. This study aimed to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County.Methods: The study used the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province, from 2013 to 2016. We adopted descriptive and regression discontinuity (RD) methods to analyze the payment effect of SIMIS. The RD analysis targeted patients (n = 7,353) whose annual serious illness expenses were between CNY 10,000 (1,414 USD) and CNY 30,000 (4,242 USD), whereas the descriptive analysis was used for data of the patients compensated by SIMIS (n = 2720).Results: The results of RD showed that the actual medical insurance payment proportion increased by about 2.5% (lwald = 0.025, P <0.01), inside medical insurance self-payment proportion increased by about 2% (lwald = 0.020, P <0.10), and outside medical insurance self-payment proportion decreased by about 1.6% (lwald = -0.016, P <0.05). The descriptive results showed that patients with serious illnesses mostly chose to go to a hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out-of-pocket medical expenses were still high.Conclusion: The medical technology level of Jinzhai County could not meet the needs of patients with seriously illnesses, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of the rural residents was insufficient. The high out-of-pocket expenses increased the possibility that only people with good economic conditions could benefit from the reimbursement of SIMIS, resulting in inequity.

scholarly journals An Empirical Study on the Influence of the Basic Medical Insurance for Urban and Rural Residents on Family Financial Asset Allocation

2021 ◽  
Vol 9 ◽  
Author(s):  
Shenglin Li ◽  
Yifei Yang
Keyword(s):  
Developing Countries ◽  
Asset Allocation ◽  
Medical Insurance ◽  
Mediating Effect ◽  
Financial Asset ◽  
Rural Residents ◽  
Measurement Models ◽  
Basic Medical Insurance ◽  
Urban And Rural Residents ◽  
Basic Medical

This paper empirically examined whether participation in the Basic Medical Insurance for Urban and Rural Residents impacted families' allocation to risk assets and risk-free assets using the Heckman two-step method, which is based on the China Household Finance Survey micro data of 2013, 2015, and 2017. The results showed that participation in the Basic Medical Insurance for Urban and Rural Residents can promote families' reasonable choice between risk assets and risk-free assets to a certain extent. To be specific, the risk asset investments are squeezed out for the originally risk-seeking families, while the risk-free asset investments are squeezed out for the originally risk-adverse families. We tested the robustness of the benchmark model and the mediating effect model with different definitions of risk assets and risk-free assets. Also, the analysis of the mechanism showed that this increases families' risk perception—turning their risk attitude more cautious and their investment attitude more rational. To further consolidate the social security attributes of the Basic Medical Insurance for Urban and Rural Residents, behind its high coverage, we should also pay attention to its influence on the investment preferences of families with different social and economic statuses, thereby giving full play to its role in promoting the development of China's financial market. In future research, we can also try to use measurement models such as PSM-DID models, and find the connections and progressive relations between different models, in order to obtain the inquiry results of different dimensions. For the direction of further research in the future, we believe that can be used to test whether the conclusion whose data configuration of the basic medical insurance for family financial assets choice influence is a universal in developing countries, to explore the developing countries to promote the health security system for the influence of its national household financial asset allocation and the corresponding policy recommendations.JEL Classification: D14, G11, H55, I18.

scholarly journals The effect of the universal two-child policy on medical insurance funds with a rapidly ageing population: evidence from China’s urban and rural residents’ medical insurance

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinjie Zhang ◽  
Jingru Huang ◽  
Ying Luo
Keyword(s):  
Medical Insurance ◽  
Insurance Fund ◽  
Ageing Population ◽  
Fertility Intention ◽  
Rural Residents ◽  
Basic Medical Insurance ◽  
Urban And Rural Residents ◽  
Child Policy ◽  
Insurance Funds ◽  
Basic Medical

Abstract Background With the rapid growth of the ageing population, the operating burden of China’s basic medical insurance fund is becoming increasingly heavy. To counter rapid population ageing and ameliorate a series of problems, China has adjusted its fertility policies several times. On January 1, 2016, the universal two-child policy was implemented. This study analysed the impacts of the adjustment to the fertility policy and potential improvements in fertility intention on the insured population and medical insurance fund sustainability. Methods We used an actuarial science method and took the urban and rural residents’ basic medical insurance (URRBMI) of China, which covers most urban and rural residents, as an example to build a dynamic forecast model of population growth and a dynamic actuarial model of medical insurance funds. Results Compared with the original policy, under the current fertility intention (40%) with the universal two-child policy, the ageing of the population structure of URRBMI participants will decline significantly after 2026, and individuals aged 65 and over will account for only 19.01% of the total participants in 2050. The occurrence of the current deficit and accumulated deficit of the URRBMI fund will be postponed for one year to 2022 and 2028, respectively. If fertility intentions continue to rise, the ageing degree of the population structure will decrease, and the deficit would be further delayed. Conclusions The universal two-child policy is conducive to improving the degree of overall population ageing, delaying the occurrence of a URRBMI fund deficit, and improving the sustainability of URRBMI funds. If fertility intention increases, the effects would be stronger. However, since the adjustment of the universal two-child policy has a certain time lag, it will take time to demonstrate this impact. Therefore, while actively promoting the universal two-child policy, other measures should be taken, such as improving the fertility desire among couples of childbearing age and reforming medical insurance payment methods.

scholarly journals Analysis of the Effect of Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China: A Case Study in Jinzhai County

2020 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Medical Insurance ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Out Of Pocket Expenses ◽  
Annual Average Number ◽  
Technology Level

Abstract Background: In 2003, China established a New Rural Cooperative Medical System (NRCMS) for rural residents to alleviate the burden of medical expenses among rural residents. However, its reimbursement for high medical costs was insufficient. Therefore, China gradually established the Serious Illness Insurance System (SIMIS) based on NRCMS. After receiving payment through NRCMS, patients in rural areas who met the requirements of SIMIS policy would receive a second payment for their high medical expenses. This study aimed to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County. Methods: The study used the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province, from 2013 to 2016. We adopted descriptive and regression discontinuity (RD) methods to analyze the payment effect of SIMIS. The RD analysis targeted patients (n = 7,353) whose annual serious illness expenses were between CNY 10,000 (1,414 USD) and CNY 30,000 (4,242 USD), whereas the descriptive analysis was used for data of the patients compensated by SIMIS (n = 2720). Results: The results of RD showed that the actual medical insurance payment proportion increased by about 2.5% (lwald = 0.025, P <0.01), inside medical insurance self-payment proportion increased by about 2% (lwald = 0.020, P <0.10), and outside medical insurance self-payment proportion decreased by about 1.6% (lwald = -0.016, P <0.05). The descriptive results showed that patients with serious illnesses mostly chose to go to a hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out-of-pocket medical expenses were still high.Conclusion: The medical technology level of Jinzhai County could not meet the needs of patients with seriously illnesses, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of the rural residents was insufficient. The high out-of-pocket expenses increased the possibility that only people with good economic conditions could benefit from the reimbursement of SIMIS, resulting in inequity.

scholarly journals Analysis of the Effect of Rural Residents Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China:A Case Study in Jinzhai County

2020 ◽  
Author(s):  
Yang Li ◽  
Guangfeng Duan ◽  
Linping Xiong
Keyword(s):  
Economic Burden ◽  
Rural Areas ◽  
Descriptive Analysis ◽  
Medical Insurance ◽  
Rural Residents ◽  
Serious Illness ◽  
Medical Expenses ◽  
Out Of Pocket Expenses ◽  
Annual Average Number ◽  
Technology Level

Abstract Background In 2003, China established a New Rural Cooperative Medical System(NRCMS) for rural residents, which had alleviated the burden of medical expenses of rural residents, but the reimbursement for high medical was insufficient. Therefore, China had gradually established a Serious Illness Insurance System (SIMIS) on the basis of NRCMS. After the payment of NRCMS, patients who met the requirements of SIMIS policy would be given a second payment to further alleviate the economic burden of patients with high medical expenses in rural areas. The purpose of this study is to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County. Methods Based on the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province from 2013 to 2016. We adopt descriptive and regression discontinuity (RD) method to analyze the payment effect of SIMIS. The RD analysis object (n = 7353) was the patients whose annual serious illness expenses were between CNY 10,000 and CNY 30,000, and the descriptive analysis object (n = 2720) was the patients compensated by SIMIS. Results The results of RD showed that the actual medical insurance payment proportion (AMIPP) increased by about 2.5% (lwald = 0.025, P < 0.01), inside medical insurance self-payment proportion (IMSPP) increased by about 2% (lwald = 0.020, P < 0.10), outside medical insurance self-payment proportion (OMISPP) decreased by about 1.6% (lwald = -0.016, P < 0.05). The descriptive results showed that the serious illness patients mostly chose to go to hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out of pocket medical expenses were still high. Conclusion The medical technology level of Jinzhai County could not meet the needs of seriously illness patients, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of rural residents was insufficient. The high out of pocket expenses increased the possibility that people with good economic conditions could enjoy the reimbursement of SIMIS, resulting in inequity.

scholarly journals Mixed Methods Research on Satisfaction with Basic Medical Insurance for Urban and Rural Residents in China

2020 ◽  
Author(s):  
Xiaofang Liu ◽  
Fang Yang ◽  
Wenwei Cheng ◽  
Yanyan Wu ◽  
Jin Cheng ◽  
...  
Keyword(s):  
Latent Variables ◽  
Medical Insurance ◽  
Public Trust ◽  
Perceived Quality ◽  
Total Effect ◽  
Research Subjects ◽  
Rural Residents ◽  
Basic Medical Insurance ◽  
Urban And Rural Residents ◽  
Basic Medical

Abstract Background There are few studies on satisfaction with integrated basic medical insurance for urban and rural residents (URRBMI), and satisfaction is not very high due to the complexity of its policies and differences among the insured. The aim of the present study was to explore the factors that influence satisfaction with URRBMI in China and to provide scientific suggestions for the government to effectively manage and improve the policy.Methods An explanatory sequential design in mixed method research was used. Quantitative study adopted a three-stage stratified cluster sampling method to randomly select the guardians of pupils who had participated in the URRBMI ( n =1335). A quantitative study was conducted to calculate latent variables’ score and path coefficient between latent variables by SmartPLS3. 0. With public trust, public satisfaction and perceived quality as the target variables, the important-performance analysis (IPA) was used to explore the important but insufficient performance factors, which were the key elements to improve satisfaction of URRBMI. A purposeful sampling strategy was used to get qualitative research subjects from quantitative research subjects according to satisfaction level. A qualitative study was conducted using semi-structured interviews and the thematic analysis method was used to summarize the interview data.Results Perceived quality to perceived value with a total effect of 0.676 ( t =31.964, P <0.001), perceived quality to public satisfaction with a total effect of 0.737 ( t =41.270, P <0.001), and public satisfaction to public trust with a total effect of 0.634 ( t =31.305, P <0.001) were three strongest paths. IPA showed that public satisfaction and perceived quality were key factors for public trust and that perceived quality was of high importance and low performance for public satisfaction. The policy quality was a determining factor for perceived quality. Qualitative research showed that the most unsatisfactory aspect for the insured was the policy quality.Conclusions This study found that improving quality is key to improving public satisfaction and public trust. The government should focus on improving and ameliorating the quality of basic medical insurance for urban and rural residents to enhance satisfaction and trust among the insured.

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