Study On The Impact Of Basic Medical Insurance Reimbursement In The Elderly Health Care Utilization

At present,China has basically realized the coverage of medical insurance.The rapid development of the medical insurance system has affected the medical service utilization of the elderly to some extent.However,Because of the existence of two different medical insurance reimbursement way in our country ——full payment and instant settlement,the elderly as the emphatic population of the medical insurance policy,under the medical insurance full payment system,the basic medical service utilization is not satisfied,this is contrary to the original intention of the system design.Moreover,with the increase of China's floating population,there are more and more people facing the problem of long-distance medical treatment and payment of medical expenses,and the impact of the medical insurance payment system is bound to be greater.So,is there a real difference between the use of medical services by the elderly under two different forms of medical insurance reimbursement? From this perspective,this paper will focus on analyzing the impact of two different medical insurance reimbursement methods on the utilization of medical services in the elderly,use of hospital medical service,treatment and preventive health services utilization effect,and put forward corresponding countermeasures to make up the deficiency of the current basic medical insurance system,so as to realize the long-term goal of equalization of basic public health service.This paper firstly combed the related research results at home and abroad,defined the concept of the basic medical insurance reimbursement method and the health service utilization,and analyzed the mechanism of medical insurance reimbursement method.Secondly,this paper analyzed the development history and current situation of the basic medical insurance system and the reimbursement method from the macro perspective,as well as the health status of the elderly in China and the status quo of its medical service utilization.Then,using the China Health and Retirement Survey Tracking(CHARLS)2013 year data,this paper empirically analyzed the effects of two different medical insurance reimbursement methods on the utilization of outpatient medical service,the utilization of hospitalization,self-treatment and the utilization of preventive medical services based on the Logit model,the study found that :(1)From the perspective of outpatient medical service utilization,it is more likely to use the outpatient medical service to the elderly underthe method of immediate settlement reimbursement;(2)From the point of view of hospitalization medical service utilization,the instant settlement reimbursement method has no significant effect on the utilization of medical service in the elderly;(3)From the perspective of self-treatment,the immediate settlement reimbursement method has a significant negative influence on the self-treatment and utilization of the elderly patients compared with the insured elderly under the full reimbursement method of medical insurance;(4)From the point of view of preventive medical service utilization,it is more likely that the preventive medical service will be used in the immediate settlement reimbursement method by the elderly.In general,the medical insurance instant settlement reimbursement method has the promotion effect on the medical service utilization of the elderly in China.Finally,based on the research conclusions,this paper puts forward corresponding Suggestions.Government departments should promote the promotion of medical insurance instant settlement nationwide,at the same time,strengthen the basic medical insurance outpatient service plan,improve basic medical service capabilities and levels,and improve the basic medical and promote preventive care service fee into the scope of medical insurance coverage.