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Objective:To understand the impact of adjusting national drug reimbursement list(NDRL) have on the benefits of patient covered by Basic Health Insurance ( BHI ) , medical insurance fund expenditure and specific drug marketing . Methods: Based on the survey data of medical service utilization situation of national inpatients participated BHI, to summarize and analyze the change of drug usage from 2009 to 2011. Results: In 2011, the drug expense of the national inpatient covered by BHI is approximately 132.7 billion yuan, increased by 37% compared to that of 2009; among which, the expense of entry drug accounts for about 76% out of the total drug use. In 2011, new increased expense on drug use is 13.5 billion, which increased to 98% compared to that of 2009. Conclusion:Adjustment of NDRL had little effect on total drug expenses increasing, but lead changes of the drug expense structure; and expense on some new entry drugs increased obviously. The focus of future adjustment of NRDL could gradually transfer from guaranteeing on basic medicine use to the promotion on clinical rational drug use.
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Objective: To analyze the status and general trend of urban residents’ health equity and health performance. Methods:Adopting standardization of concentration index, the extended concentration index and health performance index. Results: Chronic disease and self-assessed health of urban residents in China gradually improved from 2007 to 2011, while disability of those people did not improve significantly. Health inequity exists among urban residents with different incomes. Chronic disease and disability are inclined to the poor while self-assessed health is inclined to the rich, but the unfair degree has decreased gradually by year; the self-assessed health and the health performance of chronic disease has been improved from the comprehensive health level and equity, the disability sustains serious condition. Conclusion: China’s new health care reform does not significantly improve the domestic urban residents’ health equity and health performance, the objective set of the health care reform in China should pay more attention to health equity.
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To evaluate the impact of two medical insurers' policies on the hospitalization of people with schizophrenia and the economic burden they faced during a period of rapid health services reform in China. A comparative analysis was made of Urban Employee-Basic Medical Insurance [UE-BMI] and Urban Residents-Basic Medical Insurance [UR-BMI] policies on the medical management of schizophrenics, and was compared with hospitalization expenses, insurer reimbursement data and other information collected from the HMO [health maintenance organization] and social insurance agencies on the care of people with schizophrenia in Changsha in 2010. In-depth interviews were also conducted with relevant managers. Compared with inpatients covered by UR-BMI, the inpatients of UE-BMI were admitted to higher level medical institutions and were prescribed expensive second generation antipsychotics [SGA] medicines. Nevertheless, the hospitalization service utilization and cost of inpatients' hospitalization under UE-BMI were far less than that of inpatients under UR-BMI. The insurance level difference between two medical insurance schemes influences the treatment regimens and benefits received by patients. Furthermore, the integration of schizophrenia management into the outpatient services pooling fund for special diseases[OS-PFSD] can appropriately reduce hospitalization utilization, which, together with the payment way reform and the prescription of reasonable medications, can significantly reduce the overall hospitalization cost for patients
Subject(s)
Humans , Female , Male , Schizophrenia , Hospitalization/economics , Insurance, Health/economics , Practice Patterns, Physicians' , Antipsychotic AgentsABSTRACT
Objective To probe into a doctor-seeking medical management model for China's urban hypertension patients under medical insurance, and enhance the level and quality of medical insurance management. Methods Hypertension patients were surveyed with a structured questionnaire, and the staff at community health centers and medical insurance management centers received qualitative interview. Results The hypertension patients are found to see doctors mostly at community health centers and tertiary hospitals; complaints among hypertension patients for existing medical insurance vary with their areas, mostly targeting on complicated reimbursement procedure, high threshold of medical insurance payment and low level of reimbursement. Recommendation Experiment with the single-disease payment for hypertension, with the total prepayment in per capita and per disease; greater efforts in hypertension control in communities, with more favorable medical insurance policies for communities;elevated collaboration with medical institutions at all levels, and building and standardizing the management information network for hypertension patients.