| From the 1950s,cooperative medical scheme in China’s rural landed.With the development of society and the changes of the economic base,cooperative medical scheme still continue to develop and revitalize.In recent years,due to the aging population and disease spectrum changes,critical illnesses are particularly significant to social development,people’s health and social stability in rural areas.The basic purpose of carrying out the protection of critical illnesses of rural residents is to reduce the burden of medical expenses when the rural residents suffer from serious illness,to improve the social welfare and realize the fairness and justice of the society.Although the establishment of the new rural cooperative medical scheme and serious illness insurance to a certain extent,protect the health of farmers,reducing the medical burden of farmers.However,the implementation of the catastrophic disease insurance system for rural residents in China is short and the systems are not mature enough.There are some known and unknown problems in the existing practice.Due to the uneven development of the economy and the unequal distribution of medical resources,the level of protection of catastrophic disease of farmers there are differences.Based on this,this paper constructs the evaluation index system for the effect of the implementation of the catastrophic disease insurance of rural residents,and uses this index system to evaluate the catastrophic disease insurance effects of the farmers in the eastern,central and western regions of China,and then analyzes the factors affecting the protection level.This study was conducted in Nanjing,Zhenjiang,Taicang,Anhui,Hefei,Ma’anshan,Sichuan,Chengdu,Inner Mongolia,Hulunbeier City Health Bureau of the new rural cooperative medical management and human resources and Social Security Bureau of Medicare Fund Management Center Based on the research on the operation status and management system of the major rural disease prevention system in different regions,this paper selects two provinces respectively in the eastern,central and western regions to evaluate the effect of rural residents’ catastrophic disease protection,and compares the eastern and western regions farmers in the coverage of serious illness,financing,compensation,medical burden than the difference.And to explore the relationship between each index and actual hospitalization compensation ratio by multiple linear regression,so as to explore the existing problems in the system of catastrophic disease insurance and put forward practical and effective suggestions.The main contents and research results are as follows:(1)This paper constructs the evaluation index system of the catastrophic disease implementation effect of rural residents in China.From the coverage,financing,compensation and medical burden than the four aspects of China’s rural residents to assess the level of critical disease protection,including serious illness insurance indicators,and the new rural cooperative schemeindicators.And the weight value of each evaluation index on the implementation of the catastrophic disease insurance of rural residents in China was established by analytic hierarchy process(AHP).The results show that the most important one of the index is the financing of serious illness insurance.The higher the fund raising level of a region,the stronger the fund’s ability to pay and resist risks.The higher the proportion of reimbursement for serious illness insurance,the higher the per capita compensation amount.Therefore,the level of funding is a fundamental factor affecting the level of critical illness protection.The second-class index,which has the greatest impact on the implementation of the serious illness insurance for rural residents,is the fund utilization rate of the catastrophic disease insurance fund.The use of the fund is the basic factor to study the serious illnessinsurance level in this area.(2)The empirical study on the effect evaluation of the rural residents’ catastrophic disease implementation effect in the typical areas of the eastern,central and western regions shows that the farmers’ beneficiaries ratio and medical expense compensation level are higher in the western region than in the eastern region and the medical expense burden ratio is lower.But the farmers’participation rate,lower than the eastern region,the overall effect value of the implementation shows that the eastern region is higher than the western region.In western China,farmers’ health needs are small,and they are sensitive to the cost of participating in health insurance,resulting in low participation rate of farmers in the western region.But this does not affect the enthusiasm of that farmers insured whose own physical condition is poor.So in the western region,the beneficiary ratio from serious illness insurance is higher,and the level of medical expense compensation is higher than it in the eastern region as well.Although the burden of medical care in the eastern region is high,patients with serious illnesses can receive higher compensation and obtain better quality medical resources.(3)The empirical study shows that the proportion of compliance fees,fundraising level and fund utilization rate are positively correlated with the actual hospitalization expense reimbursement rate of serious illness,that is,the higher proportion of compliance fees,the higher the fundraising level and the fund utilization rate,the higher the actual hospitalization reimbursement rate for farmers.Beneficiary ratio,medical expenses level and per capita net income were negatively correlated with it.The higher the income ratio,the higher beneficiary ratio and the cost of medical expenses,the lower the actual hospitalization reimbursement ratio of farmers.The introduction of commercial insurance companies also have a positive effect on improving the actual level of protection of serious illnesses.The fund management level of serious illness insurance,pay line and cap line have a not significant effect on the level of protection.Due to the implementation of a catastrophic disease insurance system for farmers in China is relatively short,around the practice are not the same,more difficult to obtain relevant data.At present,the research on the system of catastrophic disease protection for rural residents mostly stays in the construction of the index system,or on the individual provinces and municipalities to carry out the evaluation of the protection level of the pilot areas.This paper not only constructs a scientific evaluation index system,but also evaluates the level of protection in the eastern,central and western regions,and can comprehensively reflect the situation of the serious illness insurance of the farmers in our country. |
