Cost Sharing On Hospitalization Expenses In Basic Medical Insurance

Objective: To analyze the level and the construction of cost sharing on hospitalization expenses in basic medical insurance, to find out the reasons of the heavy expense burden, to put forward suggestions for promoting basic medical insurance.Method: Collecting basic medical insurance of China, Sichuan and this administration area; collecting data of medical insurance operating conditions, investigating materials of hospitalization expense and cost sharing from 2001 to 2005 in order to make a qualitative research; using focus group discussion method to research the cost sharing problems and suggestions by producing focus subject discussing of specialists from the pointed hospitals and the medical insurance institution.Results: 1. The cost sharing on hospitalization expenses in basic medical was heavy. 2.The totally applicants own expense in the largest proportion of the cost sharing . 3.Heavy cost sharing mostly reflected in elderly, applicants of serious diseases, low-income applicant and those in hospitals at tertiary level. 4.The policy factors closely related to cost sharing were the medical insurance payment standard, the payment way to hospitals and the establishing of supplementary medical insurance. 5. The reasons that due to the heavy cost burden of applicants were complicated, including out-of-controlling factors such as social aging, the change of disease spectrum ;and some in-controlling factors such as medical insurance policy, management mechanism ,the way of payment and the method of cost control, the deficiency of China's medical and health system and so on.Conclusions: In order to effectively control the rising of unreasonable medical expenses, to reduce the cost sharing burden of applicants, it's important to reform the medical insurance properly and build up multiple medical insurance system , to improve the supervision and management measures of pointed hospitals; to support the primary health services; to reinforce the reform of our country's medical and system reform.