Comparison Of The Guarantee Effect And Management Efficiency Of Different Medical Security Modes

Nowadays,different countries in the world have established their own medical security systems,and most countries consume a large amount of human,material and financial resources in medical and health-related fields every year.According to data from the OECD official website,per capita health expenditure in OECD countries reached $4,224.1 by 2019,which increased by 30% in the ten years from 2009 to 2019.However,the results of increasing financial investment in health care have varied widely.Take the United States,which is dominated by commercial medical insurance,as an example.The latest data shows that in 2017,the financial expenditure on medical and health care in the United States reached3.2 trillion dollars,among which the expenditure on medical and health care accounted for 18% of GDP.American medical technology is among the best in the world,but from the point of view of output,the American model of health care is not very efficient.First,from the perspective of average life expectancy,from2007 to 2016,the average life expectancy of the United States has been fluctuating between 78.1 and 78.7 years,which ranks the lowest compared with other countries with the same level of economic development.Second,whether the burden of medical expenses is effectively reduced.In 2017,the per capita medical and health expenses of the United States were as high as 10,000 US dollars,ranking first compared with other countries in the world.Third,the coverage rate of basic medical insurance.In a real sense,the coverage rate of public medical insurance in the United States is only 35.9%.Even with the people who participate in commercial medical insurance,the coverage of medical insurance is still relatively limited.After the Trump administration took office in 2018,the repeal of the Affordable Care Act caused the number of uninsured Americans to rise to 8.5percent,or about 27.5 million.People hope that by increasing financial input in health care,they can obtain the corresponding medical services.But for various reasons,such as the high medical costs reduced health services accessibility,information asymmetry between doctors causing moral hazard,medical and health technical personnel professional enough,etc.,these reasons will not only waste of medical resources,causing reduced efficiency,and even can make the guarantee of medical security mode effect.To evaluate the security effect and operational efficiency of different medical security modes from multiple perspectives can not only provide rich experience for the "troublesome" medical reform in countries around the world,but also have a positive significance for the improvement of people’s livelihood.By comparing the guarantee effect and management efficiency of different medical security modes,we can intuitively analyze the advantages and disadvantages of different medical security modes.Based on the analysis of the guarantee effect of four typical medical security systems,this paper selects several indicators from multiple dimensions,and uses the analytic hierarchy process to score different countries,so that the comprehensive guarantee effect can be quantified for comparison.The evaluation of management efficiency is different from the security effect.It mainly evaluates the management efficiency of the medical security mode in different countries from the perspective of input-output(DEA model),and then uses the empirical model to find out the factors that affect the efficiency.These two steps can provide reference for the reform and development of China’s basic medical security system by evaluating the guarantee effect and development efficiency of foreign medical security models.The contents of each chapter and the main points of this paper are as follows:The first chapter is the introduction.The introduction mainly introduces the research background and significance,research content,research methods,literature review,innovation points and difficulties of the paper.It provides a comprehensive and systematic framework for the development of the thesis.Based on the comparison results of the guarantee effect and development efficiency of the typical international medical security models,this paper focuses on how to optimize the reform of China’s medical security system.The literature review at home and abroad mainly focuses on the following aspects: one is from the perspective of the impact of medical security system on group health.The second is the interaction between the medical security system and the economic factors.Third,the development of the medical security system can force the government to take the initiative to balance the regional differences in the allocation of health resources and promote social equity.The fourth is to analyze the empirical research methods of domestic and foreign scholars on the efficiency or effect of the medical security system.In general,there are few literatures that compare and systematically study the guarantee effect and management efficiency of different medical insurance modes in the world,but these literatures and research methods provide important references for the topic selection research of this paper.The second chapter mainly discusses the theoretical basis of the study on the guarantee effect and efficiency of medical security system.The guarantee effect of medical security system comes from its main guarantee function,that is,health guarantee function,economic compensation function,promoting the equalization of public health service and reducing the difference of regional medical resource allocation.The second and third sections of this chapter mainly describe the economic theory and efficiency theory of the medical security system.Mainly aimed at the management efficiency and the efficiency of the evaluation methods of this article make a definition: a,theory analysis level,take the who about health system performance evaluation methods,divided into five level distribution of overall health,population health,meet the requirements of the overall level and meet the demand of distribution,and the distribution of the fiscal expenditure.Second,empirical analysis,based on DEA evaluation method,holds that management efficiency is the ratio between the ideal minimum production cost and the actual production cost that can be achieved by the input ratio of fixed elements under certain other conditions from the perspective of input.Its essence is to carry on measure with the final result of input and output.These theories and evaluation methods provide theoretical support for the index comparative analysis and model analysis in the following paper.The third chapter mainly analyzes and compares the characteristics and benefits of four typical medical security models abroad.This chapter from the differences of system design first analyzed the characteristics of the different modes of medical security,and then around the safeguard function of medical security system and the who health performance evaluation method,from health care,fairness,economic compensation and medical service accessibility ensure the Angle of the selected 10 indexes respectively compares four kinds of typical medical security mode of protection effect,finally using the analytic hierarchy process(ahp),to integration of the indicators,analyzes the four kinds of typical medical security mode of comprehensive protection effect.It is concluded that Singapore,as a representative country of saving medical security mode,has the best overall security effect among the four countries.The score of social medical security mode is lower than that of saving medical security mode,but it takes both fairness and efficiency into account.The universal medical insurance model in Britain has the highest fairness,low efficiency,and strong synergy between medical insurance and medical development.The commercial medical insurance system in the United States is conducive to promoting the development of market-oriented medical industry and health insurance,but its overall security effect is the worst.The fourth chapter further uses the empirical model to analyze the management efficiency of four typical foreign medical security models and the influencing factors of the efficiency value.Firstly,the DEA model is used to measure the management efficiency of different medical security modes in different countries,and then the regression model is used to find out the external factors that affect the operation efficiency of medical security modes.Reference in this paper,the third chapter analysis the indicators about the protection effect of medical security system,choose the life expectancy at birth,population survival rate per capita(1-baby survival rate per one thousand people)as output index,private health care spending per person,per capita government spending on health care,the number of doctors per one thousand people,the number of nursing and midwives per one thousand people as input indicators.The regression results show that the impact of population aging on the efficiency of medical security model may not be as strong as expected,but the premise is to make adequate response.High security level in developed countries,increase financial input in medical insurance and beds per capita,per capita will lower the efficiency of medical security mode,of course,at present our country economic development level,there is a certain gap with the developed country in our country through increasing financial input,and can improve the efficiency of management of medical security mode;At the same time,the improvement of commercial medical insurance coverage will promote the improvement of the efficiency of medical security mode,but the premise is that the government carries out macro-control.The fifth chapter analyzes and evaluates the guarantee effect of China’s medical security system based on the comprehensive analysis of typical medical insurance models abroad,and puts forward targeted policy optimization suggestions by referring to foreign experience and policies.The first section of this chapter mainly analyzes the guarantee effect of China’s medical security system.It also analyzes and compares the indicators from multiple perspectives.The indicators are the same as those selected in the third chapter,and some indicators in China are compared with developed countries.The second section analyzes the problems existing in China’s medical security system on the basis of the first section.The last section draws on the international experience to put forward the corresponding countermeasures and suggestions for improving the management efficiency of China’s medical security system.For example: improve the overall planning level,reduce the treatment gap between regions and systems;By drawing on the management experience of the United States,we can develop commercial medical insurance,improve the multi-level commercial medical insurance system,and also learn from the reform of DRG medical payment mode in the United States.We should draw lessons from the management experience of the family doctor system in the UK,encourage residents to actively participate in health management,and change the concept of treatment based on prevention.Characteristics and innovations of this paper lies in: one is for four typical international medical security mode the protection effect of the multiple points of view a full range of comparative study,especially the existing literature less deposit comparative study on behalf of the state of medical security mode into the scope of comparative research,the research Angle of innovative,and more comprehensive.The second is to conduct a more in-depth discussion on various factors affecting the management efficiency of the medical insurance system.The research finds that the aging of population is not necessarily an increase in the medical insurance fund expenditure and a decrease in the management efficiency,and analyzes the internal causes and coping experience.The findings of this study are important and innovative,and have important reference significance for the reform and development of China’s medical security system in a rapidly aging society.The weakness of this paper lies in that,due to the extensive coverage of the study,it involves the comparative study of Chinese and foreign medical security models,which is not deep enough.