Study On The Integrative Development Of Commercial Insurance And Social Insurance In Chinese High-end Medical Service

Objective:Through the typical city of the development experience of integration of high-end medical service background of commercial insurance and social insurance to understand the status quo of mining,the existing problems,to enhance China’s high-end medical service development level to provide practical guidance,but also to provide relevant recommendations and Countermeasures for high-end medical services in the field of insurance development.Methods:A typical case of data using the literature review of commercial insurance and social insurance collection fusion development,through the chart of health insurance premiums and health expenditure and health insurance payment cost accounting analysis;business insurance premium income and payment of medical and health institutions and income and expenditure do correlation analysis;2013 January to 2016 December from the cost of high-end the medical outpatients in a hospital,the difference between the application of rank sum test to compare with the use of health care and medical insurance expense settlement and commercial insurance after the settlement costs;selecting a hospital from 2015 January to 2016 December in the three cataract,coronary heart disease,bronchitis disease disease patients by rank sum test to compare the same with Medicare reimbursement and the cost of Medicare reimbursement and commercial insurance claims cost differences between;using multivariate Logistic regression Analysis of factors affecting patient costs.Results:(1)Through the literature analysis of China’s health insurance premium from 2006 to 2015,a substantial increase in income,health costs accounted for continuous growth,that commercial insurance participation in social security,can promote the premium income growth,but also promote the growth of medical and health institutions,economic benefits.(2)The correlation analysis between the total premium income of Jiangsu province and the total income of medical and health institutions in Jiangsu province shows that the insurance premium income is positively correlated with the medical income of medical institutions,and the correlation coefficient is r=0.975(P<0.05).This may be related to the substantial increase in the premium income of health insurance,the increasing of middle and high income groups,the high attention to health,the high demand for medical services,and the consequent increase of medical income.(3)To a hospital in 2013 January to 2016 December,some high-end medical 196 clinic patients according to the following two kinds of classification,one is the use of medical insurance settlement fee,another is the use of medical insurance and commercial insurance after the settlement costs,using the rank sum test data of two groups were analyzed,the results showed that the use of medical insurance settlement costs were significantly higher than that of the use of insurance and commercial insurance after the settlement costs(P<0.001).(4)Collected in a hospital from 2015 January to 2016 December,coronary heart disease,cataract,bronchitis three disease patients hospitalization data,analysis of the difference between the patients with the same illness insurance reimbursement of expenses and the insurance reimbursement and commercial insurance claims costs.There were 2626 cases of cataract,13773 cases of coronary heart disease,bronchitis,2000 cases of these patients rank test and multiple factor in the total hospitalization expenses during the two Logistic regression analysis,rank sum test results show that the cost of Medicare reimbursement was significantly lower than that of Medicare reimbursement and commercial insurance claims costs(P<0.001).Multivariate Logistic regression analysis showed that the type of cost and hospitalization expense influence factors,taking group and hospitalization insurance + more patients,the higher the cost reimbursement and claims.Conclusion:Commercial insurance as an important supplement to improve public health care system of the society,can alleviate the pressure of social insurance,social insurance does not cover the scope to provide protection for their own regional columns,and the social medical insurance comparison,whether it is in the operating mode,or in the service content,more mature and professional.The effective combination of social insurance and commercial insurance can provide more medical security besides guaranteeing the basic medical needs of the broad masses of the people.In addition,commercial insurance,as a key means to improve the level of medical services,will effectively alleviate the severe medical situation caused by the aging population in china.Secondly,the integration of commercial insurance and social security can also allow Business insurance company to enjoy more favorable policy support from the government,so as to realize the sharing of commercial insurance and social insurance in the medical field.