The Efficiency And Effectiveness Of New Rural Cooperative Medical System Funds Under The View Of Universal Health Coverage

Basic medical security system in our country at present is still in the stage of "low level, wide coverage", the medical insurance fund operation management ability is still low, excessive treatment, prescription, excessive use of large-scale inspection equipment such as illegal behavior caused by the excessive waste of medical resources and unnecessary consumption phenomenon significant health insurance funds, the fund use efficiency is not high, the medical insurance fund run huge risk, safeguard ability is limited. Therefore, in line with the principles of sustainable development of medical insurance fund, the current problem to be solved urgently is how to better management of fund operation, makes certain fund to secure more actual benefited range, effectively reduce the medical burden of farmers. Research is helpful to promote the study of the theory of the social medical insurance fund use efficiency and broaden the research Angle of view. At the same time, the response to the requirements of the deepening health reform policy, at the same time is conducive to the current financing standard, improve the system of new farmers and the actual security, reduce the happening of the poverty due to illness, and sustainability of the guarantee fund.[Purpose]1. The definition of universal health coverage under the perspective of the new concept of agriculture fund use efficiency;2. Build index system of efficiency evaluation of new farming and fund use;3. Evaluation of new farming and the service efficiency of funds;4. Put forward the policy Suggestions to improve efficiency in new farming and fund use.[Methods]Retrieve the source of this study include the foreign language database ISI Web of knowledge, such as PubMed, Chinese full text database and Chinese journal, ten thousand, VIP, and so on. Search term "efficiency", "insurance", "funds", "efficiency" and "new farming close" etc and searching strategy, through literature database to collect relevant research literature at home and abroad. At the same time in the world health organization(who) and the national and the local administrative department of health website collect relevant policy documents and data report.On the basis of widely collecting documents, using content analysis, secondary analysis and system analysis method, a study is to understand the present stage involved in the medical insurance fund use efficiency research related nouns and concept;Summarize the literature about the service efficiency of funds the establishment of the selection of evaluation index and index system;Combing existing research for might be in the influence factors of the service efficiency of funds.[Results]1. Universal health coverage Angle under the definition of the service efficiency of fundsOf new farmers in the concept of universal health coverage in the concept of the service efficiency of funds can be defined as: under certain funding level, through to the fund management as a whole, and payment of compensation for patients and institutions to obtain the highest level of the population, services, and financial risk protection cover.2. New farming in fund use efficiency evaluation(1) after 8 years of development, farmers around the hubei province new fund development growth, scale grows. Funding level from 2008 in 2015 to less than 100 yuan per capita growth per capita 500 yuan. The level of government spending tends to be stable, maintain at around 80%;(2) new farming and fund is still in the stage of "low level, wide coverage", inpatient and outpatient compensation and benefit "rapid growth. But the hospital actual compensation than to peaked in 2012 and 55. 3%, and then decline year by year, in 2015 in the hospital actual compensation ratio is only 53. 1%;(3) new farming and fund use in good condition, the overall utilization rate remained at 80% the following, fund utilization rate is only 75. 14% in 2015. Relative to the commercial health insurance, the new agriculture in fund management cost is extremely low, the management cost is less than 5 yuan per capita, the rate of overall management costs less than 1%.3. The effectiveness of the NCMS fund(1) based on the above theory and consider the availability of data, farmers will now new fund use effect evaluation of defining the scope is mainly from the following three dimensions: namely fund allocation situation, different level agency service utilization and the actual compensation in hospital(2) in general, residents in the county of hubei province in hospital than 80. 51% to the patient, use as much as 71. 77% of the total compensation fund in hospital. In 2015, 19. 49% of outflow of patients in hubei province agriculture consumes 28. 23% of the new fund. Second, the hospital function of towns and townships to undertake further weaken, the proportion of hospitalized patients with towns and townships and fund consumption decreasing year by year, to 2015, the proportion of patients hospitalized in towns and townships to further reduce 38. 21%, consumes only 21. 79% fund lines at the same time.(3) there may be a "medium level economic region phenomenon", this phenomenon can be described as: specific good relative to the economic development of poor areas, economic development area, patients' outflow phenomenon and the outflow of funds is more significant, in towns and townships function weakened more obvious.4. Efficiency analysis of NCMS funds based on DEA- Malmquist indexOverall, sample counties new farming and fund comprehensive efficiency, pure technical efficiency and scale efficiency are rise. Longitudinal comparison, each fund use efficiency values of standard deviation of the counties in reducing, minimum rise, shows the whole, the new farmers and the service efficiency of funds in ascension, the efficiency of the county had low efficiency value promotion. Transverse comparison, all counties of differences between the service efficiency of funds. Further analysis of the different economic grouping and grouping of the difference between different regions. Economic level better county average efficiency value is higher, at the same time, the same as above, exists the phenomenon of "medium level of economic development". Medium level of economic development region the average comprehensive efficiency, pure technical efficiency and scale efficiency The lowest. And funds efficiency difference between different terrain group is not obvious.Analyze the dynamic efficiency of fund found that technological progress is more effective than changes in the efficiency and the scale effects of the changes in the whole production index, the increase of new farmers and the service efficiency of funds, from promoting medical services provide technical progress, improve the service supply quantity is more effective than blindly increasing investment. The phenomenon in different is the more obvious degree of regional economic development, better economic level in the higher level of medical technology to provide matching. Technical progress, however, the differences in the topography of different performance is not obvious, the change of efficiency between different terrain is mainly brought by the management and scale change.[ Conclusions]Many factors that affect the efficiency of NCMS funds, in addition to the affected by the level of economic development and the limitation of the geographical factors, also with the medical service system, new agricultural funds management on both sides of their efficiency and has a lot to do with each other. Health care and health supplement each other, should give play to the role of health care regulation, supervision and standardize medical service, improve the medical quality control health care expenditures;To build a "rational layout, appropriate scale and hierarchy optimization, responsibilities clear, fully functional, efficient" medical service system, to promote prevention, early diagnosis, early treatment, guide the patients for medical treatment, reasonable adjust health expenditure structure, and under the same financing scale, increasing the service efficiency of health care. Finally, dynamic coordination mechanism of health care, medical treatment, the checks and balances, harmonious development.