ABSTRACT
Objective:To analyze the filing mechanism for cross provincial immediate reimbursement of medical insurance in China, so as to provide reference for optimizing the filing mechanism and improving the filing accessibility of insured personnel.Methods:Taking the filing policy of cross provincial immediate reimbursement of medical insurance in 2019 as the research object, on the basis of a comprehensive understanding of the national filing policy background, 90 coordinating regions in Zhejiang Province, Hubei Province and Ningxia Hui Autonomous Region were taken as survey samples to evaluate the relevant policies and extract key parameters, including filing identification methods, filing-related settlement benefits and filing ways. The parameters were compared and analyzed by using descriptive statistical methods.Results:The results of the survey showed that in terms of identity recognition methods, the provision of various supporting materials(residence permit, work certificate, etc.)was still the main way to carry out identity recognition for medical insured persons in different places.Filing-related reimbursement benefits were mainly adjusted by limiting the area of medical insurance treatment and adjusting the benefits parameters(reimbursement ratio). In terms of filing channels, 51(56.7%)sample co-ordination areas had realized at least one remote filing mode.Conclusions:The inclusiveness of filing identity verification mechanism for the floating population needs to be further improved, the filing-related treatment policies need to be further improved, and the convenience and standardization of filing channels need to be strengthened.
ABSTRACT
BACKGROUND: In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy. METHODS: Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up < 7%. RESULTS: HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P < 0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P < 0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022). CONCLUSION: The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.
Subject(s)
Adult , Humans , Blood Glucose Self-Monitoring , Blood Glucose , C-Peptide , Diabetes Mellitus, Type 2 , Fasting , Follow-Up Studies , Glucose , Glycated Hemoglobin , Insulin , Insurance , Insurance, Health, Reimbursement , Korea , Multivariate Analysis , PrevalenceABSTRACT
Colorectal endoscopic submucosal dissection (ESD) is not yet fully popularized in Korea, but is increasing steadily. The outcomes of colorectal ESD in Korea are comparable to those in Japan and other countries. ESD-related complication rates are decreasing as experiences accumulate. Particularly for rectal laterally spreading tumors, ESD is becoming more prevalent than transanal endoscopic microsurgery. Standard indication, qualified training system, and full medical insurance coverage should be established for the procedure to become popular in the long run.