期刊论文详细信息
BMC Health Services Research
A preliminary analysis of the effect of the new rural cooperative medical scheme on inpatient care at a county hospital
Hengjin Dong2  Lennart Bogg1  Linghao Wang2  Hua You2  Xiaofang Liu2  Huimei Hu2  Yuan Wu2  Shengnan Duan2  Chiyu Ye2 
[1] Global Health, Department of Public Health Sciences, Karolinska Institute, Solna, Sweden;Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
关键词: Utilization;    Access;    Cost;    Length of hospital stay;    Equity;    China;    Universal health coverage;    Hospital;    Inpatient;    NCMS;    Health insurance;   
Others  :  1137417
DOI  :  10.1186/1472-6963-13-519
 received in 2013-01-04, accepted in 2013-11-15,  发布年份 2013
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【 摘 要 】

Background

China in 2009 committed to reach universal health coverage by promoting three forms of health insurance; NCMS for the rural population, UEBMI for formally employed urban residents and URBMI for other urban residents. NCMS has expanded to near universal coverage in rural China since launching in 2003. The objective of this study aimed to assess the effect of NCMS on inpatient care utilization from 2003 to 2012 at Longyou county hospital, Zhejiang province.

Methods

The research was conducted at Longyou county, Zhejiang province. All registered inpatient admissions from January 1, 2003, to June 30, 2012, were included in the study. The PLSQL Developer software was used to select the interesting variables in the hospital information database and saved in an Excel 2003 file. The interesting variables included the patients’ general information (name, gender, age, payment method), discharge diagnosis, length of hospital stay, and expenditure (total expenditure and out-of-pocket payment). Two common diseases (coronary arteriosclerotic disease and pneumonia) were selected as tracer conditions.

Results

292,400 rural residents were enrolled in the Longyou county NCMS by 2011, 95.4% of the eligible population. A total of 145,744 inpatient admissions were registered from 1 January 2003 to 30 June 2012. The proportion of inpatients covered by NCMS increased from 30.3% in 2004 to 54.2% in 2012 while the proportion of inpatients covered by UEBMI increased from 7.7% in 2003 to 14.7% in 2012. The average expenditure for UEBMI insured inpatients was higher than the average for NCMS insured inpatients, although the gap was narrowing. The average length of hospital stay increased every year for all inpatients, but was higher for UEBMI inpatients than for NCMS insured inpatients. For both tracer conditions the results were similar to the above findings.

Conclusions

NCMS has improved coverage height for its enrollees and resulted in increased cost of care per inpatient admission at the county hospital. However, wide differences persist between the two insurance systems in coverage height. Both systems are associated with increasing lengths of stay and rising cost per inpatient admission. We found that around 30% of inpatients were not covered by any of the two public health insurance systems, which calls for further studies.

【 授权许可】

   
2013 Ye et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Zhao H: The significance of the new rural cooperative medical scheme for China. Theor Invest 2007, 5:107-109.
  • [2]Xian H: Innovation and practical significance of the new rural cooperative medical scheme. Gansu Soc Sci 2009, 4:9-12.
  • [3]Wang Z: Reform ideas on the new rural cooperative medical care. J Harbin University of Commerce: Soc Sci Ed 2010, 6:18-21.
  • [4]Shen S, Hou X: Fragmentation of China’s social medical insurance system and system integration goals. Soc Sci Guangdong 2012, 3:19-25.
  • [5]Sun X: The integration of new rural cooperative medical scheme and the urban residents basic medical insurance. Acad J JinYang 2010, 6:35-37.
  • [6]Sixth national census in 2010 data bulletin of Longyou [http://wenku.baidu.com/view/fbbee03d0912a216147929d8.html webcite]
  • [7]People’s Lives [http://www.longyou.gov.cn/zjly/jrfc/201204/t20120416_117829.htm webcite]
  • [8]Rules of the urban employee-based basic medical insurance in Zhejiang province [http://www.law-lib.com/law/law_view.asp?id=36784 webcite]
  • [9]Lan Z, Lu M, Lin C: Sustainable development thinking on the new rural cooperative medical scheme for Longyou county. Zhejiang Clin Med J 2009, 11(8):861-863.
  • [10]Wang S, Xu L, Lin C, Wang H: The Operation of the new rural cooperative medical scheme funds in Longyou county in the past two years. Chin Rural Health Ser Adm 2007, 27(4):250-252.
  • [11]Cao X: Present situation and exploration of the new rural cooperative medical scheme. Hosp Manage Forum 2010, 11(27):61-64.
  • [12]Cai M: The new rural cooperative medical scheme and hospital development. Contemp Med 2006, 11(14):34-37.
  • [13]Li H: The influence of the new rural cooperative medical scheme to the county hospital. J Qiqihar Med College 2007, 28(17):2104-2105.
  • [14]Li Y, Shen S: Analysis on the realistic foundation of the integration of Chinese three basic health insurance systems. Chinese Health Insurance 2010, 1:23-26.
  • [15]Victora CG, Hanson K, Bryce J, Vaughan P: Achieving universal coverage with health interventions. Lancet 2004, 9444(364):1541-1548.
  • [16]Suraratdecha C, Saithanu S, Tangcharoensathien V: Is universal coverage a solution for disparities in health care? findings from three low-income provinces of Thailand. Health Policy 2005, 3(73):272-284.
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