The Analysis Of Factors Affecting Inpatient Expenses Of The New Cooperative Medical Scheme Residents In Three Counties Of Jinan City

The total cost of health care in the world and its proportion over the gross domestic product grow quickly, the total health expenditure has become a huge burden of national financial expenditure, of course including our country. Medical expenses include clinic and inpatient cost, and inpatient expenses takes a major proportion. Hence, in order to control health expenditure, inpatient expenses should be first controlled.The New Cooperative Medical Schemes (NCMS) is mainly about comprehensive arrangement for serious disease. The NCMS fund is mainly used for inpatient expenses compensation for farmers, and taking into account the out-patient cost. The inpatient expenses of rural residents increase year by year, the inpatient expenses reimbursement of NCMS, to a certain extent, enhance the ability of farmers to protect economic risks of serious illness. However, due to the coverage and the rate of compensation are not high, the benefit of majority farmers from NCMS is weak because most of the compensation is offset by the growth of inpatient expenses. Therefore, studying the factors of inpatient expenses of the NCMS residents is very important for controlling the growth of inpatient expenses and the sustainable development of the NCMS. counties of Shandong Province, this study aims to explore the effective way to reducing the inpatient expenses of NCMS residents, to supply theoretical evidence for adjusting the policy of NCMS, and to promote the sustainable development of NCMS.Methodology:In this study, stratified sampling was adopted to select samples. According to the local economy level, the counties of Jinan City were chose, included Zhangqiu County (high economic level), Changqing County (middle economic level) and Pingyin County (low economic level). The follow up survey of 2009 was based on the survey of 2007, three towns were selected randomly from the extracted six towns of each county in 2007, the same six villages of each town were selected, then about 20 households of each village were selected randomly from the 30 households in the survey of 2007, in conclusion, a total of 984 households were selected. After logic checking and proofing, panel data of two years was formed. The final sample size of this study was 6916. A quantitative analysis was used to estimate the inpatient expenses difference among NCMS residents, and the factors affecting inpatient expenses. Statistical methods were mainly descriptive analysis, single factor analysis and multiple linear regression analysis.The major results include:1) The proportion of inpatient people in rural reseach residents in 2006 was 48.0‰, and 39.0‰in 2008 respectively. From the overall perspective views, the average inpatient expenses per admission were 6876.70 yuan, 6755.83 yuan in 2006, and 7030.30 yuan in 2008 respectively.2) The proportion of admission in county hospitals was 49.0% and 32.1% in township hospitals respectively. The average inpatient expenses per time in township hospitals were 2983.32 yuan, and 6098.41 yuan in county hospitals,15500.00 yuan in city and above level hospitals.3) The average number of stay in 2006 was 13.43 days, and 14.10 days in 2008 repspectively, which was significantly higher than the average length (8.6 days) of stay among the overall country medical institutions in 2008. When hospitalization days increase 1%, inpatient expenses will increase 0.41%.4) Inpatient expenses of NCMS residents were respectively 7552.22 yuan in Changqing and 7272.46 yuan in Pingyin, and 5686.49 yuan in Zhangqiu, where was relatively lower. 5) In 2006, the inpatient expenses of 86.4% NCMS residents were reimbursed, and which was 88.7% in 2008. The average reimbursement proportion per admission in 2008 was 21.83%,2.40% higher than 19.43% in 2006. The average reimbursement proportion per admission of township hospitals was the highest in two years, respectively 25.92% and 32.83%, which in 2008 was 6.91% higher than that in 2006, followed by county hospitals, which was respectively 15.56% and 17.69%.Conclusion:The inpatient expenses of NCMS residents had a certain level of growth. The medical institution which NCMS residents chose was mainly county hospitals, and then was township hospitals. Inpatient expenses increased with the level of medical institutions and the number of hospitalization days. There was significantly difference of inpatient expenses among the three counties. The coverage of NCMS reimbursements was broad, but the actual reimbursement proportion was low, and decreased with the level of medical institutions. Therefore, it is need to take measures from several areas to control the growth of inpatient expenses for NCMS residents.Suggestions:1) Increase the construction of primary health services institutions, and improve the utilization of primary health care institutions. Through establishing the NCMS policies which are inclined to primary health care institutions, it hopes to guide farmers to use primary health services, thereby reduce the inpatient expenses.2) Shorten the average length of stay, and reduce the number of unjustified hospitalization days. By medical insurance and other parties to develop incentives; shorten the average length of stay reasonably.3) Improve the reimbursement proportion of inpatient expenses; further reduce the burden of disease of NCMS residents.4) Enhance the communication of the counties, improve and perfect the NCMS policies of the counties. Each county should learn the reasonable NCMS policies of other counties, to improve the implementation of NCMS, to provide a foundation to a prefecture level of pooling, and ultimately to control the rapid growth of inpatient expenses.