A Study On Benefit Incidence Analysis Of Government Subsidy Within Different Essential Medical Insurance

BackgroundThe Alma-Ata Declaration stated that universal accessed to essential health services in 1978,WHO raised the goal of universal health coverage in 2005.Accessed to essential medical services have become basic rights of residents,and essential medical insurance as an important way to protect the residents to obtain essential medical services.China has been set up the urban workers essential medical insurance since 1998,the trial of essential medical insurance for urban residents until 2007,China has already basically established the essential medical insurance system that covers different populations.Government finance is one of the main financing methods of essential medical insurance,who is benefit from the government’s essential medical insurance funds? Is there any difference in the benefits of different essential medical insurance? These problems can be clearly answered by benefit incidence analysis.ObjectivesBased on the analysis of the health service of different essential medical insurance,combined with different essential medical insurancefinancing compensation situation,analyzed the different essential medical insurance government financing subsidy benefit incidenceand fairness.By compared with different performance attribution and fairness of the government raised subsidies,we can provide evidence support and policy suggestion for the formulation and implementation of the urban and rural residents’ essential medical insurance for the government.MethodsIn the study,literature review and descriptive statistical methods were used to analyze the financing compensation of different essential medical insurance,the basic situation of the sample population and the health services utilization.The benefit incidence analysis used to analyze the benefit incidence of the government financing subsidy in different essential medical insurance.The concentration index and the concentration curve were used to analyze the benefit incidence equity of government subsidy.Results1.To analysis of different basic medical insurance financing,it found that the NCMS government financing accounted for 82.66% of the total financing,government financing of urban resident essential medical insurance accounted for 82.76%.Hospital expenditure is the main expenditure of the basic medical insurance fund.The samples of NCMStwo-week prevalence rate are 19.64%.The sample of urban residents’ essential medical insurance two-week prevalence rate is 23.43%,which is higher than the two-week prevalence rateof NCMS.The sample of NCMS two-week visiting rate is 9.28%.The sample of urban resident’s essential medical insurance two-week visiting rate is 8.44%,which is lower than the two-week visiting rate of NCMS.2.In the benefit of outpatient subsidies,the group with the NCMS obtained the highest benefit was the middle-income group,accounting for 20.70%,the high-income group obtained the lowest benefit,accounting for 19.52%.Middle-income groups benefit the best from the urban residents’ essential medical insurance’s outpatient subsidy,accounted for 24.08%.The highest-income group benefit the least from the urban residentsessential medical insurance’s outpatient subsidy,accounted for 16.36%.The highest-income groups benefit the best from NCMS hospitalization subsidy,accounted for 23.73%.Lower-income groups benefit the least from NCMS hospitalization subsidy,accounted for 17.43%.The lowest-income groups benefit the least from the urban residents’ essential medical insurance’s hospitalization subsidy,accounted for 15.29%.And the middle-income groups accounted for 24.39%.The distribution of the outpatient benefits of the NCMS was less balanced,and 12.24% of the population aged 65 and above received 26.87% subsidy.The lower the educational level of different educational benefits,the more the subsidy,the greater the distribution of benefits,the more the subsidy is relative to the population.The distribution of benefits of inpatient benefits is not balanced,and the high group and the low education group receive more subsidy.3.The concentration index of outpatient subsidies for the NCMS was 0.001,the concentration index of inpatient subsidies was 0.025,NCMS clinics focus on the curve is almost coincident with the fairness,and the fairness of the outpatient subsidies was better than the fairness of the inpatient subsidies.The concentration index of outpatient subsidies for urban resident basic medical insurance was 0.005,the concentration index of inpatient subsidies was 0.031.The fairness of the NCMS government financing subsidies is better than that of urban resident essential medical insurance.Recommendations1.Targeted to improve the government financial that input in health,make sure the fairness of residents benefit.2.Increasing the investment in grassroots medical services,guarantee different people have the equal chance to acquire the medical and health services3.To calculate the medical insurance fund expenditure precisely,determine the reimburse plan in reasonable.4.Formulate the urban and rural essential medical system scientifically and rigorously,make sure that both urban and rural residents benefit fair.