The Study On The Operative Effect Evaluation Of The Critical Illness Insurance Of New Rural Cooperative Medical System In Xi'an City

Objective: The paper found some problems in running process through the analysis and evaluation of the critical illness insurance of new rural cooperative medical system in Xi'an. Based on these problems, the paper put forward some countermeasures and suggestions such as clearly orientation and perfection of the financing mechanism to improve the operative effect and promote the sustainable development of the critical illness insurance.Methods: The paper used a method combining the theoretical and practical analysis. Firstly, it reviewed the literature about the medical insurance evaluation and the research status of the critical illness insurance. Based on the statistical reports, the paper built a scientific and operability evaluation index system about the critical illness insurance of new rural cooperative medical system in Xi'an. Secondly, the paper made a brief analysis about the present situation of the critical illness insurance from five aspects: the fund collection, the usage of fund, the benefit of participant, the subsection compensation, as well as the high compensation. Lastly, using Principal Component Analysis(PCA), the paper evaluated and ranked the operative effect of new rural operative medical system in 10 counties in Xi'an.Results: According to the results of principal component analysis, the paper used 2 principal components to take the place of 9 old indicators. First, component F1 reflects the compensation of the critical illness insurance, which includes three indexes: the compensation per capita, the actual compensation ratio and the self-paid ratio. The score of component F1 in Weiyang District was the highest. The scores of Yanta, Baqiao, Yanliang and Gaoling District are positive while the remainders with poor operative effect got negative scores. Second, component F2 reflects the input-output condition, which includes six indexes: the total raised capital, the utilization of fund, the number of beneficiaries, the benefit rate, the security level and the proportion of self-payment per capita in participants' income. From the scores we can see that Baqiao District is the highest one. Changan, Lintong, Lantian and Gaoling got positive scores and the remainders received negative, especially Yanta, the lowest one. Finally, based on the scores of F1 and F2 in each area, the paper constructed component F, a comprehensive evaluation model, using the variance contribution rates as weight. According to all the statistic of component F, Baqiao, Weiyang, Gaoling and Yanta Districts got positive score, and the other six districts which account for more than half of the total samples received negative. This result suggests that the critical illness insurance not works very well in Xi'an.Conclusion: The critical illness insurance of new rural cooperative medical system, which piloted in Xi'an in 2013, has achieved good results. Almost all the farmers in Xi'an are participants. Although the system helps ill participants getting rid of poverty, there still remain some problems to be solved.Firstly, the development of the critical illness insurance is unbalanced in different area in Xi'an. The running condition is closely related to the economic development, the areas with high level economic development have a better effect and vice versa. However, the rule is not absolutely true, Yanta District, with the best economic development level, not operated very well. Therefore, all the districts should improve the level of economic development, and at the same time learn experience from the advanced areas.Secondly, the actual compensation of the critical illness insurance was still quite low and this is a common problem in all the counties and districts in Xi'an. Farmers can't completely benefit because of the low level compensation, they still have to pay high medical treatment fee, which becomes the economic burden. That's why the effect of relieving farmers from poverty is not very well. If the bad situation goes on, the goal of establishing the perfect critical illness insurance can not be achieved. Hence, increasing the funding financing level, improving compensation programs and creating independent financing mechanisms are important measures to improve the actual compensation at the present stage.Recommendations: First, let the nature and orientation of the critical illness insurance clear. Second, establish a perfect funding mechanism of the critical illness insurance. Third, clearing the responsibilities of the parties and improve the participation mechanism of the commercial insurance companies. Fourth, build the risk-sharing mechanism and encourage more commercial insurance companies to take part in the critical illness insurance. Fifth, build a multi-level medical security system.