Evaluation Of The Implementation Of The Basic Medical Insurance About Urban And Rural Residents In Ningxia

Background: In China, the implementation of the urban and rural medical insurance system hindered the fairness of health care between urban and rural areas, increasing the financial burden of farmers. How to improve the current health insurance system and narrow the gap, effectively alleviate the pressure of rural residents to see a doctor for medical treatment, provide a fair and efficient health care services for all residents will become urgent and realistic issue.Objective: Analyze and evaluate comprehensively from fairness and various stakeholder satisfaction on the basis of analysis of medical insurance about the integration of urban and rural in Ningxia, improve the policy recommendations for medical insurance reform.Methods: Choose Guyuan of ningxia as a sample and use the method of literature review, interview method, questionnaire data, descriptive analysis, Theil index and comparative analysis to analyze date.Result:The lowest financing is mainly composed for urban and rural residents participating in insurance. It is 97.00% of the total number. Per capita funding criteria at an annual rate is 63.00 percent growth in inpatient and outpatient reimbursement ratio increased year by year.1. Fairness1.1 Per capita real benefitCompensatation of rural residents is higher than urban residents, cost level has obvious rising trend with the higher pay. Which is proved to enhance the benefit the fairness between urban and rural residents.1.2 Personal self paymentIndividual pays the cost of the Theil index is close to 0.00, indicating that it has a better fairness between urban and rural areas.1.3 The actual pay lineDifferences of Urban Residents stall actual pay line with nominal deductibles are slightly higher than rural residents, which were more than 150 Yuan, and grade differences decreased with the improvement of their pay.1.4 The actual compensation ratioThe actual compensation ratio of hospitalized residents for all kinds of stall were less than 70.00%, the gap between the nominal compensation rate were double-digit. Personal pocket costs are higher, heavier burden on patients for medical treatment.1.5 Flow of medical treatmentThe flow of hospitalized residents for all kinds of stall are concentrated in two medical institutions. Pay for the higher grade, the higher the level of the trend of medical treatment.1.6 Rural residents benefited from compensationThe basic cost of hospital costs in different years of internal flows at different levels of medical institutions are reasonable, Theil index is less than 0.05, the difference between the year of only 0.005, nearly entirely fair.2.Satisfaction2.1 Medical insurance of the integration of urban and ruralOutpatient and inpatient costs for insurance, satisfaction mean of cap line is respectively 2.40-2.64 and 2.13-2.54, indicating that satisfaction with outpatient insurance costs and the ceiling line is higher than hospitalized patients; patients from outpatient copayment, reimbursement, reimbursement procedures satisfaction mean is greater than average 3; general satisfaction and satisfaction mean about inpatient deductible amount, reimbursement, reimbursement procedures is 2.77-3.00, indicating that hospitalized patients in three satisfaction is higher than outpatients.2.2 Medical ResourcesOutpatient and inpatient on satisfaction mean of medical equipment, a doctor technical level, the attitude of the medical staff is respectively 2.43-2.57 and 1.90-2.10, hospitalized patients’ satisfaction is higher than outpatients in the three aspect; satisfaction mean of outpatients and inpatient on hospital outpatient turn, convenience of transfer is over 3.00, indicating that two satisfaction almost is close, and the satisfaction is not very high.2.3 Agencies, pharmaceutical, medical and security effects directorySafeguard mean of outpatients and inpatients were 2.40 and 1.92, hospitalized patient satisfaction is higher than outpatients. Satisfaction mean of outpatient and inpatient on work efficiency of medical insurance agencies service attitude and reimbursable medicines and medical items were close between 3.00 and 2.23-2.69, satisfaction of hospitalized patient is higher than outpatients.Recommendation:1.Calculate precisely financing and compensation levels, combine insured economic level, individual and family capacity, insurance and financing will, cost increases level of different medical institutions in order to calculate.2.Guide people to improve the pay grade from multi-channel, payment of rural residents should be consistent with urban residents, rural residents should be given the appropriate government subsidies.3.Optimization and reorganization of urban and rural health care resources, balance urban and rural medical services, more resources is given to rural areas and primary health care institutions.4.Strengthen medicare policy advocacy efforts to raise awareness of residents, improve the efficiency of agencies and medical institutions.