Study On The Effects Of Different Medical Assistance Schemes For Serious Diseases

[Purpose] With the initial establishment of universal health care system,the problem of guaranteeing the minority with serious diseases healthcare has gradually become prominent.Therefore,in this article,to further optimize the design of serious disease medical assistance system,we empirically analyzed the implementation effect of serious disease medical assistance,simulated different schemes under the same effect,and evaluated the effect of different schemes based on cost-effectiveness analysis and benefit attribution analysis.[Methods] City A in Hubei province and City B Guizhou province,which represent different schemes of serious disease medical assistance system,were selected as sample areas.We used institution survey,patient survey and key informant interview to collect policies,medical assistance databases and medical insurance databases.Descriptive statistics were used to analyze the current situation of serious disease medical assistance from the perspective of universal health coverage,and chi-square test and non-parametric test were used to compare the effect under different assistance schemes.The efficiency and fairness of simulated serious disease medical assistance schemes were evaluated respectively based on cost-effectiveness analysis and benefit attribution analysis.[Results] The results of the empirical study showed that the average hospitalization cost of the recipients of assistance was about 1.4 times as that of all the patients with serious diseases,and the average hospitalization frequency was higher than that of all the patients with serious diseases.The benefit rate of in City A(31.1%)was obviously higher than City B(17.4%).Un-reimbursable rate in City A was higher(22.1%).And the effective assistance rate in City A was lower than City B.The evaluation results of the simulated schemes of serious disease medical assistance showed that,under the same incidence rate of impoverty,fund demand decreased with the increase of the deductible,and the scheme fund demand was the highest when the inclusion standard was set.Both concentration index(CI)and Kakwani were negative,and the absolute values of the CI and Kakwani were the largest when the inclusion criteria were set.[Conclusions] Patients receiving medical assistance for severe and very serious diseases have a higher healthcare demand,and the economic burden of diseases is heavier than that of all the patients with serious diseases.The actual effect of different schemes of serious disease medical assistance is quite different.Although model 1 improved the breadth of beneficiaries,it also dispersed the limited rescue funds and did not reflect the "precision" of the rescue.The evaluation results of the simulated different rescue schemes showed that comprehensive consideration of medical expenses and family economic conditions will benefit the poor people more and help narrow the gap between the rich and the poor.This is in line with the characteristics of medical assistance and welfare medical security.