Study On The Inequality Of Medical Service Utilization Under The Coordination Of Urban And Rural Medical Insurance

In recent years,the Chinese government has been committed to the realization of a new concept of shared development,and continues to promote the equal supply of public services to face the contradiction between the people's growing needs for a better life and the development of unbalanced and inadequate development.As an important part of the integrated medical insurance system for urban and rural residents,it has played an important role in increasing the accessibility of urban and rural residents to access medical and health services,alleviating the problem of “poorness due to illness,returning to poverty due to illness” and enhancing social stability.effect.However,it should be noted that the inherent urban-rural binary division and the long-term fragmentation of the old system have not yet been fully resolved.Rural residents and urban residents still have a large gap in the utilization of medical service resources.According to the 2016 Statistical Bulletin on the Development of China's Health Care,the rural population accounts for more than 60% of China's population in that year,and its medical and health expenses only account for 25.7% of the total national health expenditure.There is a significant gap in the utilization of medical services between urban and rural residents.Based on this background the gaps between urban and rural residents in the use of medical services;second,whether the gap is reasonable or not due to opportunity inequality;Whether the urban and rural medical insurance policy has alleviated the inequality in the utilization of medical services for urban and rural residents.The research period of these issues provides some suggestions and references for the improvement of the urban and rural medical insurance system.This paper firstly reviews the existing research and related policies at home and abroad,and briefly summarizes including the two-week prevalence rate and hospitalization rate of residents.Secondly,establish a medical demand measurement model for urban and rural residents,and use the data of CHARLS(China Health and Pension Tracking Survey)in 2013 and 2015 to decompose the influencing factors of the gaps in the utilization of medical services between urban and rural residents,and try to measure the opportunities.Equality calculated the opportunity gap between urban and rural residents,and used the double differential model(DID)to empirically analyze the mitigation effect of the urban and rural residents' medical insurance system on the opportunity fairness gap.The main conclusions of the article are as follows:(1)There are obvious gaps between urban and rural residents in the utilization of outpatient services and the utilization of inpatient services;(2)Compared with the new rural cooperative medical insurance,the urban residents' medical insurance policy is more effective for urban residents.To a certain extent,the gap between urban and rural dualization has been expanded;(3)the contribution of urban and rural residents to the gap in the utilization of outpatient services is 33.36%,which affects the gap between urban and rural residents in the use of inpatient services.6%,that is,the urban and rural residents have greater opportunities for unequal access to medical services;(4)The urban and rural medical insurance system after coordinating has alleviated the inequality of urban and rural opportunities on 25.3% of outpatient expenses and 47.73% of hospitalization expenses.It will play a certain role in alleviating the gap in opportunity fairness.Finally,relevant suggestions are put forward: First,the central government should clarify the responsibility and expenditure responsibility of governments at all levels in the field of public health,establish a dynamic government investment mechanism with steady growth of fiscal revenue,and raise the level of urban and rural medical insurance financing.Second,practice a new concept of shared development,focus on low-income groups in rural areas and towns,establish a reasonable medical subsidy system or a major illness insurance system to reduce the incidence of “illness without medical treatment”;and third,strengthen the treatment of chronic diseases.Preventive work,and expand the scope of reimbursement of chronic disease drugs,and promote the comprehensive construction of healthy China.