Research On Demonstration Of The "medical Expenditure Control Standard Based On Residents" Affordability

Objective:The research was aimed to demonstrate the rationality,scientificity and feasibility of the "Medical expenditure control Standard based on residents' affordability" which is a new theory and method for the medical expenditure control, in order to provide a basis for it's improvement and application.Methods:The research surrounds the center thesis to demonstrate the "Medical expenditure control Standard based on residents'affordability". The following three methods are mainly used:(1) literature analysis method and logical reasoning for demonstrating the "Medical expenditure control Standard based on residents' affordability" is right or wrong in theory.(2) 1. econometrics model checkout method: for observing the data distribution, rebuilding the mathematical model by nonlinear fitting method and evaluating the correctness of The equilibrium model.2. contrastive studies method:for demonstrating the accuracy of the resident'surplus (Income-expenses) curve on definition the residents'affordability for medicine by compared with ELES.3. To observe the intersection's variation by build different areas'equilibrium model. (3) empirical studies method:by using empirical data for exploring the relationship between the intersection and the residents'psychological endurance, researching the intersection's distinguishability between urban and rural and demonstrating if the equilibrium point has accurately distinguished the medical burden and use of health service's difference between the residents before and after the intersection.Results:(1) The "Medical expenditure control Standard based on residents' affordability" has two constrained economic variables (1. Per capita medical expenses to income ratio 2.Per capita surplus to income ratio), which is the foundation for building the equilibrium model. There is an intersection when they are equal. The intersections is of optimality,uniqueness and stability. The people have been divided into three groups which have the different affordability by the intersection. (2) After repeated attempts, we amended the surplus (Income-expenses) curve's expression, that changed the initial log expression into inverse function expression to make it conform to the data distribution. (3) The residents'surplus (Income-expenses) curve is consistent with the ELES on definition the residents'affordability for medicine. The equilibrium intersection has little variations between different economic development areas. (4) The control standard has a higher consistency with the residents' psychological endurance. The equilibrium intersection is sensitive to reflect the urban-rural difference. The people before the equilibrium intersection have higher incidence of catastrophic health expenditure than people behind the intersection, but have lower utilization of health services and health level.Conclusions:(1) "Medical expenditure control Standard based on residents' affordability" has secure theory basis. It conforms to the equilibrium theory that in the economics and accurately reflects the residents'economic affordability. (2) The fitting method used to build the equilibrium model are correct. The fitting result is credible. (3) The surplus (Income-expenses) curve has accurately reflects the residents' affordability for medicine.(4) The equilibrium point is of stability (5) The medical expenditure control standard has a higher consistency with the residents' psychological endurance. It also can be accepted by the lowest income groups. (6) The equilibrium point is of distinguishability. It is sensitive to distinguish the difference between urban and rural areas. (7)The equilibrium point has accurately distinguished the difference of incidence of catastrophic health expenditure and use of health service between the residents before and after it. (8) The indicators used to build the equilibrium model are available. The method of building the equilibrium relationship curves is simple.In a word, this research suggests that the "Medical expenditure control Standard based on residents'affordability" that put forward by professor zheng is correct in theory, the methods used to build the equilibrium model are appropriate, results are credible. Using the equilibrium point of residents'medical consumption and affordability as the standard is rational and scientific, so it can be promoted and applied, and it will be even better in the practical application.