Researching The Operation Efficiency Of Liaoning's New Rural Cooperative Medical Care Fund Based On DEA

The new type of rural cooperative medical care system(NCMS), together with basic medical insurance system for urban employees(UEBMI) and basic medical insurance system for Urban Residents (URBMI), is one of the 3 fundamental pillars of public health care system in China. We have noticed that the fast growing of NCMS was accompanied with further concerns of its fairness and efficiency, among which the latter is more worth looked into compared to widely discussed issue of fairness. In author's point of view, NCMS's efficiency should be closely tied to managing the fund that supports the system. Take Liaoning Province as an example, low efficiency of funding and using has been observed since NCMS was implemented few years ago. Conducting research on how NCMS has performed in Liaoning should reveal some issues occurred in the nation-wide system regardless of its regional characteristics.In the first part of thesis, a wide range of existing domestic and foreign papers including both theoretical and empirical researches about NCMS and its efficiency are discussed; and thus DEA is determined as the research methodology in this thesis. DEA is considered to be superior in this context because of the fact that there is no parametric assumption is required, as well as that dimensions of data can be retained. With concentration on funding and using of the fund, empirical analysis were conducted with DEA based on data of Liaoning province from 2006-2009. Last but not least, the thesis concludes with some original thoughts of how to enhance efficiency of the system. With more details, this thesis breaks down into 5 sections:Section 1:The author introduces the background and purpose of research. Many existing papers of system effectiveness as well as materials regarding the effectiveness issues of NCMS are thoroughly reviewed. Original thoughts and research methodologies are outlined.Section 2:Panoramic introduction and assessment of DEA, the best applicable method of evaluating the effectiveness of funding and using NCMS fund of Liaoning Province, are illustrated. Considering the fact, input-oriented method is used for modeling.Section 3:Scalable traditional DEA and hyper-effective DEA are used to evaluate effectiveness of NCMS of Liaoning Province, based on 2006-2009 data. The result has revealed several problems such as over-sufficient funding in some area, output is too few, inefficient scale, etc. Causes of these problems are therefore analyzed based on these results.Section 4:Malmquist all-factor productivity index is applied to assess improvement in effectiveness of NCMS of Liaoning Province. Productivity of all the factors is broken down to the change of technology efficiency and improvement, which draws the conclusion that technology becomes inefficient in 2007-2008.Section 5:A conclusion of model result is summarized. Some suggestions and perceptions are originated by the author, such as reducing funding input, centralizing fund flow at province or city level, improving policy and efficiency of medical reimbursements.