The Accounting Principle And Application Analysis Of Quality Adjustment Factor For Health Care Service

With the economic flourishing and the science and technology progressing, in the 21st century, the quality of health care service constantly improving makes the measurement biases of its non-market output by input substitute method under national accounting increasingly revealing. Its entanglement mainly lies in that from an angle of direct output, how to measure output considering its quality influence.In view of this, this paper introduces the concept of quality adjustment factor that from an qualitative angle, describes the influence of quality for its output, and establishes intuitively and vividly the relationship between quality and output; then from an quantitative angle, calculates it in order to measure the output.Follow the logic to spread this paper, firstly, on theory, it,from the application perspective, understands and grasps the necessary concept to calculate quality adjustment factor; then determines clearly its measurement that from an angle of national accounts, induces inversely its basic form by using output lapeyres volume index, and further gets its evolutional by the defined quality adjustment life years according to insurance actuarial theory and calculus method; thus studies by case for its application to the output measurement.(1) Its conclusion is consistent with foreign empirical research conclusion, by using UK health care data to analyze actually quality adjustment factor for the output measurement, so as to confirm the operability of accounting principle of the clearly determined quality adjustment factor in practice.By analyzing and comparing the output difference, which is caused by whether using quality adjustment factor, it concludes that with compared to output without considering it, the output considering it may be undervalued or overvalued,which is against for correctly judging the change of health service output.(2) It finds during the output estimation that considering quality adjustment factor, measuring correctly volume index and growth is important and practical significance of analyzing the development of health care service industry by using China health care data.If using continuously input substitute method, it will only get the development status for the comprehensive industry of health, social security and social welfare, which can't obviously meet the special needs for social evolution and health care service development itself. This paper is, from an angle of direct output, with considering quality adjustment factor, measuring separately the output change may better avoid the above situation, and also rationally overcome the defects of input substitute method itself. Moreover, it finds during the analysis that the relatively rapid growth of health care service output in 2008 or 2009, is closely related to the implementation of medical insurance, which not only promotes the health care system reforming in China, but also helps to develop comprehensively and healthily health care service industry.The whole paper is divided into five chapters.The first chapter, firstly from the research background of problem origin, explicitly proposes "quality adjustment factor", and introduces the research significance. Then, according to systematical illustration of current research at home and abroad, it grasps the characteristics of those literatures, thus defines research orientation, and builds a detailed research framework. Finally it summarizes the author's mainly works and shortcomings in the paper.The second chapter illustrates the theoretical premise for the measurement of quality adjustment factor that firstly analyses the definition of health service output; then grasps the standard of health care service classification; on the basis,clearly defines an dimension quality of health care service, so as to understand quality adjustment factor from an qualitative view; finally interprets the output volume index in theory,which lays solid foundation for the third chapter illustrating in detail the measurement of quality adjustment factor.The third chapter depicts the measurement of quality adjustment factor that shows specifically output volume, measures concretely health care service quality, alters reasonably health service value to profoundly understand output lapeyres volume index, so as to induce inversely its basic form by the index,on the basis of which, and derives its evolutional form by using QALYs.Based on the analysis of other chapters, the fourth chapter, studies by case for the application of quality adjustment factor to output measurement that for example hospital service, from the angle of sample, combining with volume index and growth and using separately health care data of UK and China, it applies practically quality adjustment factor to the output measurement, moreover, in order to obtain important enlightenments.The fifth chapter induces the research conclusion from theory and practice, proposes the problems for further research of this paper, moreover, pointes out the reform trend for the measurement for quality adjustment non-market health care service output.