Study On The Effect Of Medical Security For The Disease Economic Risk Of Middle-aged And Elderly People Households

Reducing the medical burden of residents and making residents able to see illness is an important goal of building a medical security system.After the reform of the medical system,the problem of “expensive medical care” for residents has always existed,and the medical burden of the people has not been fundamentally alleviated.The 19 th National Congress of the Communist Party of China pointed out that the main contradiction in the new era of socialism with Chinese characteristics has been transformed into a contradiction between people’s growing need for a better life and insufficient development.Undoubtedly,building a solid medical security system and solving the problems of uneven development of medical security and inadequate level of security for the people are important expectations for a better life in the new era.At present,China’s medical security system has made breakthroughs in coverage and the construction of the security system,but in reality,how is the disease risk of residents distributed? Has catastrophic medical expenditure and poverty due to illness eased? Has the medical burden of residents changed? What is the effect of different medical insurance? The answers to these questions will have an important impact on the future development and reform of the medical security system,but most of the current research stay in a certain area or a specific time point,and the literature for long-term empirical analysis is uncommon and follow-up research is still little be compared.Under the above background,based on the national large-scale micro-panel data(CHARLS),this paper has conducted a follow-up study on the medical security effect of the middleaged and elderly people with relatively large disease economic risks.The research goal of this paper is to establish a measurement technology for disease economic analysis based on distribution and multiple medical security systems based on relevant theories and micro-investigation data,and conduct follow-up research.The research ideas of the full text follow the problem orientation.First,what is the degree of disease risk for middle-aged and elderly families? How is it distributed among different medical insurance groups? Can the medical security system share the economic risks of diseases in middle-aged and elderly families? How much is shared?Are there differences in the effects of different medical insurance groups? What are the factors that affect the effect of medical security? To further improve the effectiveness of medical security,in what areas should policy improvements be made?According to the above logic,this article is divided into six chapters on the research content.The first chapter is an introduction,which introduces the background,research significance,research goals and analytical ideas of this article;the second chapter is related theory and analysis framework;the third to fifth chapters are the core content of this article.The third chapter mainly explains the disease economic risk status of the middle-aged and elderly families and the development process of China’s current medical security system,focusing on explaining the mechanism of medical security to prevent disease economic risks;the fourth chapter focuses on the absolute(relative)risk degree.In the specific analysis,panel binary regression model,"counterfactual" analysis method,two-part model,sample selection model and other measures methods are used;Chapter 5 mainly explores the influencing factors of the effect of medical security.Based on summarizing the existing literature research,referring to the World Health Organization ’s universal coverage framework,respectively from coverage,medical cost control(including graded diagnosis and treatment of the demand side)The payment method reform of the supplier),security level(funding level and compensation scope)and management level(mainly the connection between different medical security projects)are launched;the final chapter is the summary of this article and the corresponding policy improvement suggestions.This article concludes that the economic risk of disease in the middle-aged and elderly families in China is still relatively large,and the role of medical security in mitigating the economic risk of the disease still needs to be strengthened.In terms of the economic risk of disease,the overall risk of middle-aged and elderly families is higher.About two-thirds of the respondents were diagnosed with chronic diseases;from the perspective of absolute risk,the total hospitalization rate of this group was 9% in 2011 and 13% in the other two survey years;According to the index of hospitalization and non-hospitalization,it was 4% in 2011,and reached 7% and 6% in 2013 and 2015,respectively.From a relative risk perspective,urban and rural residents’ medical insurance groups and uninsured groups are more than urban employee medical insurance groups The risks are relatively large.From the perspective of development trends,they have a relatively narrow trend with urban employee medical insurance,indicating that the degree of fairness has improved.In terms of the effect of medical security,the role of medical security in preventing economic risks of diseases is still not strong.Taking catastrophic health expenditure as an example,from 2011 to 2015,the incidence of family catastrophic health expenditure did not alleviate.In 2015,the incidence rate was still as high as 25.4%,with an average gap of 0.069 and a relative gap of 0.272;from medical insurance to poverty Given the role of medical insurance,medical insurance has little effect on alleviating the incidence of poverty,but it plays an important role in alleviating the depth of poverty.In terms of insurance types,the Urban Employee Basic Medical Insurance scheme(UEBMI)has the best effect,followed by Unified Basic Medical Insurance(UBMI)scheme and other Insurance(OI),it is worth mentioning that medical security has a very obvious effect in promoting the use of medical resources.From the perspective of medical burden,medical insurance has a mitigating effect on the absolute medical burden of the family,but it has almost no mitigating effect on the relative medical burden.Compared with people without any insurance,having insurance can reduce the absolute medical expenditure of about 14%.According to the average social medical expenses of micro-data,it can be reduced by604 yuan,but it is only significant at the level of 10%;For those without any insurance,insurance has little effect on reducing the relative medical burden.From the perspective of medical insurance types,various medical insurances are not consistent in reducing medical burden.In terms of absolute medical burden,the Urban Employee Basic Medical Insurance scheme(UEBMI)have a smaller decline,and Unified Basic Medical Insurance(UBMI)scheme can reduce the absolute medical burden by about 18%,and other Insurance(OI)has no significant effect.In terms of relative medical burden,the relative medical burden of urban employees can be reduced by about 7.5%,but the effect on medical insurance and other insurance for urban and rural residents is extremely small.Combining the factors that affect the effect of medical security,the article concludes by suggesting that the government should make efforts to further enhance the medical security effect of middle-aged and elderly families in terms of expanding the actual insurance coverage,"open source and cut expenditure",and improving the connection between different projects.In terms of "open source",it is mainly to increase the proportion of government investment in health expenses and the level of mutual assistance of medical insurance.In terms of saving expenditure,it is mainly to strengthen the promotion of graded diagnosis and treatment and improve the reform of payment methods.