Research On Measurement Of Basic Medical Insurance Guarantee Level Of Urban And Rural Residents In Ningxia

BackgroundIn October 2010,Ningxia Hui Autonomous Region integrated urban residents’ basic medical insurance and New Rural Co-operative Medical System,and established the basic medical insurance for urban and rural residents.Since then,the basic medical insurance system for urban and rural residents in Ningxia has started,and was launched in the whole region at the end of 2011.According to Ningxia department of human resources and social security,urban and rural residents in Ningxia have basically achieved their full coverage.Then,from the perspective of policy,Ningxia has achieved full coverage of basic medical insurance for urban and rural residents.However,in the face of the realization of the development goal of "Universal health care ",how about the guarantee level of its realization,and with the advancement of social security,whether there are some factors restricting the improvement of social security level,all these aspects need to be further studied.ObjectivesBased on the realistic situation of urban and rural residents’ basic medical insurance in Ningxia Hui Autonomous Region,our study measured its security level and found out its problems and main restricting factors,aimed to find out the effective and feasible paths,to promote the healthy,safe and stable development of Ningxia medical and health system,and finally realize the sustainable development of economy and society in Ningxia Hui Autonomous Region.MethodsLiterature review method was applied in this study to collect and sort out domestic literatures,statistical data,research reports and other research results on basic medical insurance for urban and rural residents,so as to provide sufficient references for this research.At the same time,expert consultation method was used to screen and adjust the measurement indexes to determine the final measurement indexes.In view of the basic current situation and existing problems of the system implementation,the fund raising,distribution,use and compensation policies are mainly understood through the interview of keys figures.When determining the weight of each index in measurement system of security level of Ningxia basic medical insurance for urban and rural residents,the coefficient of variation method and entropy weight method were used to combine the weights of measurement indexes to avoid the influence of subjective factors on the weight assignment of measurement indexes,so as to make the measurement results more accurate and scientific.Finally,the obstacle factor diagnosis model was used to analyze the factor contribution degree,index deviation degree and obstacle degree and find out the main factors which affecting security level of basic medical insurance for urban and rural residents.Results1.Construction of measurement system of security level of Ningxia basic medical insurance for urban and rural residentsIn order to measure the level of Ningxia basic medical insurance for urban and rural residents scientifically and effectively,this paper constructed a measurement framework for the level of Ningxia basic medical insurance for urban and rural residents from the perspectives of system,social economy and residents,and preliminarily selected the corresponding measurement indicators.Finally,by carrying out two rounds of expert consultation,measurement system of security level of Ningxia basic medical insurance for urban and rural residents was finally determined,which consists of three first-level indicators and eighteen second-level indicators.2.The level of basic medical insurance for urban and rural residents in Ningxia has maintained a steady growthIn this paper,the method of coefficient of variation and entropy weight was used to combine and weight measurement indexes,which can make the weight of each measurement index scientifically and reasonably.Meanwhile the linear weighting method was used to construct the measurement model,which is commonly used in multi-index comprehensive evaluation.Finally,the result value of security level of Ningxia basic medical insurance for urban and rural residents increased from 0.75 in 2012 to 0.88 in 2016.Thus it can be seen that the level of Ningxia basic medical insurance for urban and rural residents has maintained a steady growth.3.Basic medical insurance for urban and rural residents in Ningxia is at a "good level"This paper classifies the security of basic medical insurance for urban and rural residents into four levels,namely "excellent level","good level","passing level" and "failing level".The study found that the level of basic medical insurance for urban and rural residents in Ningxia is at a "good level",which indicates that the basic medical insurance level enjoyed by urban and rural residents in Ningxia is at a "good level",and the basic medical insurance demand of urban and rural residents can be well guaranteed.4.The main restricting factors of the level of basic medical insurance for urban and rural residents in Ningxia are decreasing year by yearBased on the obstacle factor diagnosis model,this paper concluded that the main factors restricting the basic medical insurance security level of urban and rural residents in Ningxia are the accumulative fund balance rate,average length of stay,the coverage of health insurance,per time medical expenses for residents and per capita individual contribution level.At the same time,through the frequency statistics of the indicators ranked in the top six in terms of obstacle degree coefficient between 2012 and 2016,the per capita individual contribution level of medical insurance coverage rate is the most important factor restricting the medical insurance level of Ningxia urban and rural residents.From the perspective of time dimension,the obstacle coefficient of its security level at the level of system,social economy and residents is decreasing year by year,from 2.5,2.0 and 1.59 in 2012 to 0.21,0.6 and 0.3 in 2016 respectively,which is confirmed by the fact that the Ningxia residents’ medical insurance security level obtained in this paper is increasing year by year.RecommendationsBased on the research results,this paper suggests that the state should increase financial support and strengthen the supervision of local government health insurance system.At the same time,local governments should reasonably calculate the disease compensation ratio and individual payment level to control the unreasonable growth of medical expenses.With the raising of economic development level,we should increase and adjust the proportion of medical and health expenditures,optimize the rational allocation of health resources,and improve the quality of medical and health services and the health literacy of residents.So as to provide a guarantee for the sustainable development of Ningxia basic medical insurance for urban and rural residents and the establishment of a higher level of well-off society.