Research on the Impact of Urban Resident Basic Medical Insurance on Unemployment / 中国卫生经济

Objective:It examined the impact of Urban Resident Basic Medical Insurance(URBMI) program launched in 2007 on labor supply.Methods:Using ordinary least square and instrumental variable estimation,the regression analysis was conducted on URBMI household survey data.Results:Although the URBMI increased the accessibility to medical services and decreased residents' financial burdens,the unemployment rate for residents with URBMI were increased by 13％.Conclusion:In respect to the problems of aging and labor force reduction in China,the policy-maker should not ignore the potential negative labor market outcomes while expanding public health insurance coverage.

Uninsured status and its influential factors among residents in Hunan Province / 中南大学学报(医学版)

Objective:To investigate the insured and uninsured status of medical insurance among residents in Hunan province and the influential factors for uninsured status.Methods:A stratified,muti-stage,cluster sampling was used to select 7 rural counties and 7 urban districts from 122 counties/districts.In each selected county/district,5 towns were chosen at random.2 villages (or communities) were further selected in each given town randomly.At last,households were selected from sample villages (or communities) using systematic sampling and all members of selected households were surveyed through face-to-face interview.Complex sampling weights were considered to estimate the coverage rate of medical insurance and 95％ confidence interval.We used logistic regression to identify significant factors for not purchase insurance.Results:The overall coverage rate of medical insurance was 95.76％(95％ CI 93.04％ to 98.49％) in Hunan residents,and 4.24％ (95％ CI 1.51％ to 6.96％) of surveyed residents did not participate in any medical insurance program.Particularly,the proportion of residents not participating in any medical insurance program approached 10.17％ among urban residents under 18 years.Age,household income per capita,without chronic disease,were found being associated with uninsured status of medical insurance.Conclusion:To achieve the goal of universal health coverage by 2020,social medical insurance department should take measures to raise the coverage rate of medical insurance among residents.

Equity on healthcare service utilization of China’s Urban Resident Basic Medical Insurance / 中国卫生政策研究

As an income redistribution mechanism, the design of Urban Resident Basic Medical Insurance ( URBMI) should reflect the inclination to take care of vulnerable populations, such as people with chronic diseases and low incomes. Therefore, whether the healthcare services of vulnerable populations have been improved, is the most important indicator to determine the effectiveness of the URBMI. Using the DID model, this paper analyzes healthcare service utilization of invulnerable and vulnerable populations before and after the establishment of URBMI ( including both outpatient and inpatient) , based on the idea that these two populations have different socio-economic and health status. Then, based on the gap between the healthcare service utilization changes of different groups, we can measure the equity in URBMI. The results show that the establishment and implementation of URBMI has indeed narrowed the gap of invulnerable and vulnerable populations with different socio-economic and health status; health-care service utilization of vulnerable populations has increased significantly, and health status has significantly im-proved. From vertical and horizontal perspectives, the results prove that the establishment of URBMI has improved the equity of healthcare service utilization among different populations across China.

Empirical Research on Influencing Factors of the Inpatient’ Actual Reimbursement Rate under the Urban Employee Basic Medical Insurance / 中国卫生经济

To discover factors affecting the inpatient’ actual reimbursement rate of urban resident basic medical insurance ( URBMI ) . Methods: Using the method of correlation analysis and multiple stepwise regression modeling to identify the influencing factors. Results: The per capita funding criteria, rate of inpatient out of pocket payment over resident annual per capita disposable income and per capita hospitalization rate have significant effect on the actual reimbursement rate of URBMI. Conclusion: It is needed to establish a sustainable steady financing mechanisms for URBMI, improve the evaluation system of reimbursement policy and gradually raise the level of actual reimbursement.