Evaluation Study On Expenditure Of Health Insurance And Countmeasures Of Shengli Oil Field

BackgroundMedical cost increase has brought enormous pressure to the social and economic development, not only increased the state spending, but also leaded to inflation and weakened the competitiveness of production. It also caused risk to health insurance funds in many countries, such as Japan, France and Spain China is the largest developing country in the world, and is in the period of rapid economic development now. In China, health care reform has lasted for years, but controling health care costs increase is still faced with difficulty, and also under pressure. Employee health care costs grew faster than revenue growth over the same period, so it take a big risk to the system of our country make a certain percentage of wages as the financing of health care insurance.Whether the health insurance fund's income and expenditure in balance is an important condition for whether it can maintain sustainable development. In the running process of health insurance around, the insurance fund in balance is always one of the focus problems which are concerned by health care sector, medical institutions and all sectors of society. The balance of the medical insurance fund is affected by both funding levels and expenditure levels, but one or two aspects will have a significant impact on the balance of the medical insurance fund. Medicare hospital costs is the main part of the fund expenditures, it not only reflect diagnosis and treatment measures to patients' diseases and the case of the disease cured, but also reflect the preferences of residents'medical practice and the patient's psychological expectations, so controling the excessive growth of hospital costs and unreasonable expenditure of Medicare funds has important significance for maintaining health insurance fund balance.Research purposeThrough the analysis of sheng-li oilfield Health insurance policy and fund balance evaluate the operation situation of health insurance funds. while taking advantage of information base of insurance 1 staff and cost of ten representatives from 2002 to 2005, Learn the distribution, composition and influencing factors of unnecessary hospitalization costs and adjust and improve the medical insurance system for sheng-li Petroleum Administration Center Social Insurance management and provide an important reference value effectively control the unreasonable medical insurance funds spending, and better protected the insured workers to receive basic health services.Major findings1) The total amount of insured workers between2001 and 2005 is basically stable, but its structure make a big change, namely, serving staff reduced by 13,397, retired staff increased by 1 million.2) health insurance fund revenue of 147.167 million yuan in 2001 increased to 252.217 million yuan in 2005, The annual average growth rate isl4.42%, overall hospital expenditures during the same period of 109,986,000 yuan increased to 252.239 million yuan, annual average growth rate is 23.06%, 8.6 percentage points faster than the former.3) The overall utilization rate of insurance fund of 75% in 2001 increased to 100% in 2005.4) The insured workers hospitalization rate of 7.04% in 2001 increased to 14.25% in 2005, the number of hospitalized persons double during 5 years the total hospital costs during the same period increased to 296.578 million yuan from the 130.653 million yuan, with an average growth rate 22.75%, secondary cost of hospitalization increased from 6886.2 yuan to 7826.1 yuan.5) 2001-2006, the flow of medicare patients to central hospital decreased year by year, the flow of medicare patients to sheng-li hospital increased year by year, the flow to other inside hospitals and outside hospitals is relatively stable, n maintained at about 40% and 7%.6) the average hospital stay shortened 4 days from 2001 to 2006, hospital stay of 12days or more decrease from 69.77% in 2001 to 57.59%, the hospital costs of average hospital stay of 12 days accounted for the proportion of total hospital costs fall from 88.64% to 77.93%.7) compared with private expenses patients, the average hospital stay of insured patients is relatively long, and the number of longer hospital stay make a larger proportion and a high cost of hospitalization.8) From the constitute of hospital costs, drug costs share the largest proportion, nearly 50%; followed by the treatment, accounting for around 11%.Conclusions and policy recommendationsThe main conclusions:1) The amount of insured workers become essentially unchanged, but ites structure has changed, in the future it will trend of a more substantial increase2)The overall expenditure on hospital payments spending growing faster than the Health insurance pool fund income,so we will adjust the current health insurance policy to control hospital spending growth overall gold3) the rate of hospitalization insurance workers doubled, total amount of hospital costs increased more than double, so control hospitalization rate is the key of control the growth of hospital spending4)Most of the insured patients tend to Central Hospital and the shengli hospital,the hospital costs of these patients accounted for 69.32% of total costs5) drug costs share the largest constitution of Hospitalization costs,followed by treatment costs6)The average length of hospital stay decreased, length of hospital stay of 12 days or more decrease in the percentage, but the hospitalization costs account for a large proportion of total hospital costs7)Compared with private patients, hospital stay and transfusion days of insured patients is relatively long, the cost of hospitalization is relatively high...