The Influence Of The New Health Reform Policy On Health Service Utilization And Burden Of Health-care Costs

"It is difficult to see a doctor,and expensive to see a doctor" is an inherent problem in the public medical field in China.In order to provide ”safe,effective and affordable ”services for China's 1.3 billon people and to achieve the goal of “Everyone has access to basic medical and health services”,China introduced the New Health Reform Policy in 2009.From 2009 to 2015,the cumulative expenditure on medical and health care at all levels reached more than 564 billion yuan,with an average annual growth rate of 20.8%,4.8 percentage points higher than the national fiscal expenditure in the same period.Under the background,this paper uses data from the China Health and Nutrition Survey.Two-Part Model and Heckman model are employed to study the influence of the New Health Reform Policy on health service utilization and burden of health-care costs.Then the paper proposes relevant policy recommendations based on the results of empirical analyses.This paper first introduces the research background,research purposes,the significance of the study,research methods,research contents and the structure of the dissertation.Then this paper combs the relevant research literature from the research on the influencing factors of medical service utilization and the research on the influencing factors of medical burden,and summarizes the existing related research.The empirical analyses are based on Becker's health demand model,Grossman's health demand model and Andersen's health service utilization behavior model.Employing the CHNS survey data from 2004 to 2011,the Two-Part Model and Heckman sample selection model were used to analyze the influence of the New Health Reform Policy on health service utilization and burden of health-care costs.Then the paper extracts subsamples of different income groups and analyzes the impact of new medical reform on medical service utilization and medical expenses burden of different income groups.The empirical research of this paper mainly draws the following conclusions:(1)the reform factor and medical insurance factors are significantly and positively related to the possibility of medical treatment for sick residents,which is significantly negatively correlated with the proportion of self-pay for residents' medical expenses,and also significantly negatively correlated with the actual medical expenses of residents.(2)The gap in the burden of medical expenses for different income groups is still huge: the reform variable has improved the possibility of seeking medical treatment for low-income groups to a certain extent,and to some extent,reduced the proportion of self-paying and medical expenses for low-income groups.However,the burden of medical expenses for low-income groups is still too heavy.At the end,this paper summarizes the empirical results of the impact of new medical reform on residents' medical service utilization and medical expenses burden,and puts forward relevant policy recommendations.Limitations of this study are also discussed.