Calculation on Medical Compensation Fees Based on the Integration of Basic Medical Insurance for Urban and Rural Residents in the Inner Mongolia Autonomous Region
- VernacularTitle:基于内蒙古自治区城乡居民基本医疗保险一体化的医药补偿费用测算
- Author:
Qing-Yuan XUE
1
,
2
;
Jing SUN
;
Yan-Cun FAN
Author Information
- Keywords: medical compensation fee; medical insurance fund; compensation ratio; urban and rural residents; integration of basic medical insurance; Inner Mongolia
- From: Chinese Health Economics 2018;37(3):35-38
- CountryChina
- Language:Chinese
- Abstract: Objective:To estimate the medical compensation fees in medical insurance fund under different compensation schemes in Inner Mongolia,and to study the feasibility of financing in the integration process of basic medical insurance for urban and rural residents in Inner Mongolia Autonomous Region.Methods:Based on the method of ratio method,original difference GM (1,1) model,Delphi method and moving average,the medical compensation fees under different compensation schemes in Inner Mongolia in 2015 was calculated.Results:Ignoring the factors such as pay line and cap line,the total compensation for medical expenses under the five medical compensation schemes were 18.778 billion yuan,25.355 billion yuan,30.351 billion yuan,32.346 billion yuan and 46.04 billion yuan.Conclusion:Based on the measurement of medical compensation under different compensation schemes,it calculated the financing amount of the integration of medical insurance,analyzed the feasibility of the basic medical insurance financing in Inner Mongolia.In the treatment of growth factors,insurance factors and other indicators,the innovative use of a variety of methods combined approach,scientific and effective calculation of the growth factor and insurance factor,revised a part of the annual growth factor which had large growth,the insurance factor value was too high and other problem,in order to accurately assess the medical compensation.