Necessity And System Design For The Elderly Medical Security System

Objective: On the basis of analysing the necessity of the elderly medical security system from four angles: the trend and effects of aging, health service demand and utilization of the elderly, health expenditure rising and the limitation of our medical security system for the old and comparing the characteristic among different countries and some areas in China, this paper will explore a new elderly medical security system include coverage, financing mechanism, payment style, provision manner, which is seasoned with the development of our society, then put up feasibility demonstration and reasonable proposal, so as to alleviate economic and social stress lead by aging and make the goals of"the old have their medical security"and"2020 everyone has basic health care"come true.Methods: Choosing the elderly more than age 65 as research object, describe aging trend, health service demand and utilization of the elderly, and the medical security status for the old using related datum; analyse the effects of health service utilization and health expenditure using correlation analysis and logistic regression, the datum root in total health service survey and hospital expense of 43 general hospital in Liaoning provice; calculate expenditure demand of the elderly medical security system using Moderation security model; compare elderly medical security system in different countries and areas through demonstration analysis; analyse the functions of community health service in the elderly medical security system by SWOT analysis.Results: Aging trend and characteristics means that our medical security system will face the challenge of chronic disease rate rising and health expenditure increasing. Related datum of total health service survey in Liaoning province and all state shows health service demand of elder people is higher than the other age group, the factor of medical security has prominent influence for health service utilization and health expenditure; otherwise our medical security system for the old has some limitations, all of these determine we should found a new elderly medical security system at present.Both demonstration analysis of the elderly medical security system, include system frame, coverage, financing mechanism, payment style, provision manner, and comparative analysis of elderly medical security system in representative countries and areas show that elderly medical security system is essential and viable. SWOT analysis of community health service displays that CHS has some strengths in zone, price and secive diversification; lack of talent, distemperedness of two-way referral system, faultiness of health insurance policy, lack of management experience are the weaknesses; medical model change, aging development, the significance of CHS become obvious, attention and support of government at all levels are the opportunities which CHS should face, but CHS would receive some challenges, include faultiness related legal, lack of evaluate and supervise system, and competition with other agencies.Calculating the expenditure demand of the elderly medical security system by moderation security model, the result shows the capital which social medical security fund input to the elderly medical security should reach 168.36 billion yuan, which will account for about 74% of actual social medical security expenditure. Suppose the proportion of medical expenditure for the elderly in all medical expenses is fixed, then our country should devote 166.14 billion yuan to the elderly medical security in year 2010, and this amount will reach 3172.43 billion yuan in 2050.Conclusion: The trend and effects of aging, health service demand and utilization of the elderly, health expenditure and affection factors, the limitation of our medical security system for the old all determine the necessity of the elderly medical security system, as the same time, domestic and international experience, related theory and policy analysis and expenditure calculate prove elderly medical security system is feasible in institution and technology. So we shoule explore financing mechanism, payment style, provision manner (especially the function of CHS), strengthen the relationship between the elderly medical security system and other medical security systems, establish related law and policy as soon as possible, so as to alleviate economic and social stress lead by aging and make the goals of"the old have their medical security"and"2020 everyone has basic health care"come true.