Study On Insurants' Utilizations And Expenditure Of Medical Services And Influencing Factors

BackgroundBasic Medical insurance (BMI) for urban employees has developed more than 10 years in China, which has many advantages to conquering shortcomings of the Government Insurance Program and Labor Insurance Program. But there are still many challenges, such as for insurants, what changes had occurred to medical service utilizations and expenditures, as well as the influencing factors? The past studies on the issues are not comprehensive and systematic, especially on insurants. The study on purchasing medicines is nearly vacant. Therefore the topic was studied.ObjectivesUsing quantitative and qualitative methods, the study described the basic performance of BMI, compared the insurants' utilizations and expenditures of medical service, explored the impacts of BMI protocol, medical providers and insurants on the utilizations and expenditures of medical services, in order to put forward recommendations for further improvement of the BMI policy, increase the efficiency of resources use and cost control.MethodsThe study used qualitative and quantitative research methods, data of daily registration and special investigations, the field work data and secondary hand data. The field data included the dynamic data of medical service utilizations and expenditures of 20067 insurants randomly sampled, information on providers and from stakeholders interview in the survey city. For quantitative data, descriptive analysis, comparative analysis and multi-factor analysis methods were used. The qualitative information was summarized, collated and analyzed by the theme. The study extended four-step model of the health service utilization and expenditures. The models used in the study included: Logistic regression for whether utilizing health services or not, commulative model for the probability of medical services utilizations,...