Study On The Influencing Factors Of Medical Expenses Of Urban And Rural Residents

From a risk management perspective, when the residents face health risks of accidents, they will suffer from all kinds of labor costs and expenses, and the medical cost is an important index to measure the extent of the loss of health risk. The huge medical expenses is the main reason for poor residents in the current, the so-called "poverty caused by illness". In order to solve this problem, the government led the implementation of the new rural cooperative medical care, basic medical insurance for urban residents, basic medical insurance for urban workers and critical illness medical insurance. The basic medical insurance can reduce the economic burden of disease of residents through compliance of medical expenses. But health risk compensation is still the main means to compensate after health accident. And passive compensation may even cause that health risk prevention consciousness is weak. Therefore it is necessary to take a more active health risk prevention and health risk control. Through analyzing health service utilization and analyzing medical expenses, and it can have important reference on the selection and optimization of health risk management measures.This paper mainly includes two parts:firstly, through analyzing the distribution of medical service utilization and medical expenses, the text chooses the binary choices logistic model and generalized linear model based on Gamma distribution. And the text analyses the influencing factors of outpatient rate, outpatient expenses, inpatient rate and inpatient expenses. According to the empirical, the text found that self rated health is the key factors, and then the text identifies the health risk factors from the self-rated health point of view. So it can control medical expenses from risk prevention perspective; secondly, based on the analysis of medical expenses, the text calculate per capita funding level of urban and rural residents critical illness insurance in Shandong province. So the current level of funding has been tested whether can effectively compensate the residents medical expenses. Critical illness medical insurance of urban and rural residents compensates residents according to the actual compliance medical expenses especially inpatient expenses. Based on the analysis of medical expenses, the text calculate per capita funding level of urban and rural residents critical illness insurance. the current level of funding has been tested whether can effectively compensate the residents medical expenses, and the government can avoid the households to be poor because of illness.The main results show that:(1) basic personal characteristics (gender, age), personal health characteristics (self-rated health, preventive care, chronic disease information, self-care ability) are significant factors that influenced the medical service utilization and medical expenses, and hospital type and treatment will significantly affect medical expenses, and self rated health is the key factor influencing the utilization of medical service and medical expenses;(2) from the self-rated health point of view.the empirical analysis of health risk factors found that personal characteristics, individual objective health characteristics, personal behavior and life characteristics, family and economic characteristics, regional characteristics are the risk factors of health excluding prevention and health care factor;(3) Based on the analysis of medical expenses, taking Shandong Province as an example, the estimated average per capita financing of urban and rural residents critical illness insurance should be 40 yuan, so the current level 32 yuan per capita financing is low.(4) the business insurance companies should give full play to the professional advantages and talent advantages in critical illness medical insurance. The business insurance companies should not only provide quality services for settlement of claims, also should establish the risk management mechanism, so that the business insurance companies can analyse health risk, monitor in medical institutions of medical behavior, control the growth of medical expenses, and improve the efficiency of fund use.