Research On The Current Running Situation Of Medical Insurance For Major Diseases In Urumqi New Rural Cooperative Medical System

Objective:Based on analysis of the cost reimbursement,the improvement of poverty caused by diseases and the influencing factors of hospitalization expenses of medical insurance for major diseases in the new rural cooperative medical system in Urumqi,to understand the advantages and problems in the operation of the system,provide experience and data support for the implementation of serious illness insurance.Methods:It analysis the change of the compensation person and hospitalization expenses of medical insurance for major diseases in the new rural cooperative medical system in Urumqi between 2012-2015 by using the Description Statistical Method,comparative analysis on the improvement of poverty caused by diseases before and after compensation,establishment of multiple linear regression model to explore the influencing factors of hospitalization expenses of patients with major diseases.Based on the results of the interview with the new rural cooperative medical staff,the paper summarizes the advantages and disadvantages of the major disease medical security system and gives some suggestions.Results:1.During the period of 2012-2015 in Urumqi,the compensation person of major diseases in the new rural cooperative medical insurance continued to grow,199 persons increased to 1154 persons,the top three major diseases of patients with end-stage renal disease,mental illness and breast cancer;2.The total cost of inpatients with major diseases,the average hospitalization expenses and the actual compensation ratio showed a sustained growth trend,the average hospitalization expenses increased from 13502.95 yuan in 2012 to 15615.36 yuan in 2015,the actual compensation ratio increased from 63.91% in 2012 to 66.53% in 2015;3.Compared with the new rural cooperative medical system,the average hospitalization expenses and the actual compensation ratio of the new rural cooperative medical care for major diseases were at a high level;4.Drug costs account for the highest,all above 48.86%,medical expense proportion is falling,decreased from 43.94% in 2012 to 39.93% in 2015,2012-2015 drugexpenditure structure change rate is 49.96%,the greatest impact on the total cost of change;5.After the new rural cooperative medical insurance for major diseases compensation the occurrence of poverty caused by diseases was significantly reduced,the improving people increased significantly from 110 in 2012 growth to 689 persons in 2015,is better than that the new rural cooperative medical insurance;6.Effects of major diseases in the new rural cooperative medical insurance inpatient cost factors including gender,age,duration of hospitalization,hospital level,repeated hospitalization,drug costs,medical costs and material costs.Conclusion: The actual compensation ratio of the new rural cooperative medical insurance for major diseases is relatively high,the selection of typical diseases,to some extent alleviate the poverty caused by diseases,but there are limited sources of funds,guarantee the narrow coverage,management mechanism is not perfect.Suggestions to promote the basic medical insurance for urban and rural integration,accelerate the implementation of serious illness insurance system,standardize the clinical path and the implementation of DRGs system,optimize the income structure of medical staff and deepen the reform of drug system,the implementation of grading treatment,strengthen the health management of chronic disease.