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The Transformation of Medical Security Fund Management System and Evaluation

Chinese Health Economics.2013;(11):18-20,21. doi:10.7664/CHE20131106

Medical security fund is the core of medical security system. The traditional system of medical security fund management has enabled various governmental departments to play positive roles, and has controlled the growth of expenditure. Since the Reform and opening-up, along with the reform of medical security system, a scientific and reasonable fund-raising mechanism has been established, the management of medical security fund has been societalized, and the supervision and regulation mechanisms of registered healthcare agencies have been initially established, all of which further promote the reform and development of healthcare system. But the existing management system is not perfect, and a medical security fund system which adapts to China's national conditions and the needs of the development of healthcare system must be further explored.

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Fairness Evaluation Analysis on Pubic Health Resource Allocation in China:Empirical Analysis Based on the Benchmarks of Fairness Analysis

Yi WEI

Chinese Health Economics.2014;(1):32-34. doi:10.7664/CHE20140109

Objective:To evaluate the China’s fairness of health resource distribution in recent years. Methods: Index of priority for health services (IPHS)and index of resources distribution ( IRD) were applied to test the allocation status of health resources with the horizon and vertical comparison analysis. Result: With the development of new health care reform, the public health service gradually improves and the basic health needs are further satisfied. The unfair distribution kept the same among different regions, and the provincial health supply and demand are not matched. Conclusion: Public health resource allocation should keep focus on reducing the divergence from rural-urban dichotomy and narowing inter-provincial gaps.

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The Prospective and Simulation on the Financing Amount of Basic Medical Insurance in Liaoning

Li GUAN ; Yejing DONG

Chinese Health Economics.2014;(1):29-31. doi:10.7664/CHE20140108

Objective: Using system dynamics to provide prospective and simulation of double exponential smoothing on Basic Medical Insurance Fund and related indexes from 2013-2022 in Liaoning. Methods: Using the post testing to select the best value of αand projecting the whole procedure of forecast into the software of system dynamics to get the prospective result. Results: In ending of simulation, the increase of fund and other objects will reach about 2 times as much as those in 2013 , and out-of-pocket in total expenditure on health will be declined greatly. Conclusion: The economy of province is developing fast while Basic Medical Insurance is in relatively lower level.

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Demographic Structure, Environmental Quality and Resident Expenditureson Health

Xiaoqing YE ; Juan XU

Chinese Health Economics.2014;(1):48-50. doi:10.7664/CHE20140114

Objective: To explore the impacts of demographic structure, environmental quality on household health care expenditures. Methods: Based on 2000-2010 inter-provincial panel data, the method of dynamic panel SYS GMM is used. Results:(1) The rise of elederly dependency ratio promotes residents’ health care expenditures; (2) the decline in juvenile dependency ratio is also the acceleration factor of health care expenditures; (3) the seriousness of environmental quality pollution expands the health care demand. Conclusion: To improve the health status residents, it is needed to implement the medical insurance system for the eldly, construct the health care insurance system for the children, besides, environment protection should be people oriented.

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The Price Control Issues in Health Care (Part Three)：The Price Control on Physician’s labor

Chengli HUANG

Chinese Health Economics.2014;(1):42-44. doi:10.7664/CHE20140112

Price control is common in the national health system in the worldwide, in which the price control to physician's labor in China’s health system is relatively unique phenomenon. This mean of using the most important procedure factors in price control of the whole system has caused a series of adverse consequences: the interference of signal function of price, medical institutions relying too much on drug sales, the doctor’s behavior alienation, and agency relationship between doctor and patient failed resulting in the high tension of doctor-patient relationship. China’s health system got sick, and the price control to physician’s labor is the most important source. Let the price of doctor’s labor decided by the market mechanism is an important chose to regain the healthy development for China’s health system.

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The Measurement Analysis of Doctor Workload Based on the Analytic Hierarchy Process

Yongguo SUN ; Lili QI ; Aitian YIN

Chinese Health Economics.2014;(1):39-41. doi:10.7664/CHE20140111

Objective: To search for the weighting the doctor’s service value and method to give the payment to doctors. Methods:From the hierarchy of medical service items, medical service items are classified, the weight of medical service item are calculated by analytic hierarchy process (AHP) , the Harvard University doctor workload measurement model is established. Results: According to the weight of medical service items, to calculate the workload of doctors integrated with practical work quantity. Conclusion:By applying the theoretical results into practices, the estimation system of doctor workload was smoothly operated in the organization.

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Medical Insurance Affecting on the Health of the Elderly in China：based on the exmination of limited information of the maximum likelihood method

Xiguo LIU ; Jian WANG

Chinese Health Economics.2014;(1):24-25. doi:10.7664/CHE20140106

Objective: Based on overcoming the adverse effect of endogenous problem of causality; to study the effect of health insurance for the health of the elderly. Methods: To apply limited information maximum likelihood method and introduce instrumental variables for two-phase analysis. Results: The more to types of medical insurance participated, the easier the risk of chronic diseases could be reduced, but unfavorable to improve self-reported health. Conclusion: The government should develop social insurance under New Rural Cooperative Medical System, to improve the abilities of the elderly in participating in medical insurance.

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The Impact of Hospital Distance on the Chinese Inpatient Service Demand in Rural Areas：The Application of Discrete ;Choice Model

Ling LI ; Jian WANG ; Jia YUAN

Chinese Health Economics.2014;(1):11-13. doi:10.7664/CHE20140102

It is always an important academic and policy issue to understand the impact of hospital distance on Chinese inpatient service demand in rural areas. It employs household survey data collected from 97 villages in Shandong in 2006 and 2008, and investigates the influences of hospital distance on the demand of famars in rural areas. The discrete choice model is constructed to estimate the inpatient service demand function for patients in rural areas. The empirical analysis finds that the hospital distance is significantly affecting Chinese inpatient service demand in the rural areas. The longer the distance increases, the lower the visiting rate drops. In addition, the impact changes with the changes of hospital level; the lower the primary hospital is, the higher the impact would be. It paper provides new evidence for the understanding of the geographical characteristics of medical health care.

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Discussion on Moral Hazard and Its Influences under China’s Health Care Reform

Ling LI ; Ying LI ; Jia YUAN

Chinese Health Economics.2014;(1):5-10. doi:10.7664/CHE20140101

It is a well-recognized difficult empirical task to disentangle the moral hazard effect from adverse selection impact by using the health insurance data in the empirical research of health economics. In the research, the unique social experiment in China’s health care reform, which enables cleanly identify moral hazard is applied. Using individual-level hospital patient data, it estimates the impact of the reimbursement rate increase on Chinese patients’ demand for health care service. Difference-in-Difference Propensity Score Matching approach and find strong evidence for moral hazard are approached. For instance: if the reimbursement rate increases by 5% while other factors remain the same, the corresponding health care service expenditure will increase by around 7%. The finding also has important implication for policy making. Chinese government pledges to lower the average individual out-of-pocket cost from the current 37.5% of total health care service cost to 30 % in 5 years. According to the former estimation, if the goal of the policy is successfully achieved, moral hazard problem itself will cost Chinese health care system around 200 billion yuan.

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Restudy on Accounting Method of Community Health Services Cost

Chunyan XIAN ; Yan JIANG ; Wei CHENG

Chinese Health Economics.2014;(1):60-62. doi:10.7664/CHE20140119

In order to explore more reasonable and scientific accounting method of community health service costs, to improve the accounting method system of community health service cost. In the current existing community health services costing methods, based on the analysis of hospital cost accounting methods system, analyze and imitate the accounting method of hospital costs, establish a more scientific and implemented accounting method system of community health service costs: divide parts of clinics scientifically, redesign the center acollation method of indirect cost, confirm different cost accounting methods for different cost accounting objective and provide suggestion for the improvement of project cost accounting.

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