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.
ABSTRACT
Objective: To analyze the effects of the catastrophic disease insurance of New Rural Cooperative Med-ical Scheme ( NRCMS) on alleviating the economic burden of patients in Beijing, and evaluate the effect of the policy implementation. Methods: Based on high, middle and low economic development levels and the implementation pro-ceedings of catastrophic disease insurance of NRCMS, this paper selects 3 districts of Beijing, from which it chooses two or three villages and towns with the highest numbers of catastrophic disease patients, in order to understand the opera-tional status quo of the catastrophic disease insurance through in-depth interviews with managers. This paper conducts questionnaire survey among all catastrophic disease patients from the sampled villages and towns, and uses 497 valid questionnaires received to understand patients' subjective feelings and collect relevant data of family income and medical expenditure of catastrophic disease patients in 2013. Then it carries out data docking with the platform of NRCMS man-agement centers and measure the economic burden of catastrophic disease patients. In this paper, quantitative and qualitative data are analyzed using statistical and thematic analyses, respectively. Results: The catastrophic disease in-surance of NRCMS has significantly played an important role in reducing the average medical expenditure of catastroph-ic disease patients and improving the actual compensation ratio in varying degrees. However, the incidence of cata-strophic health expenditures has not significantly improved. Conclusion: This paper suggests to increase deductibles and reimbursement ratios of catastrophic disease insurance in order to broaden reimbursement directory and other initiatives to improve the compensation level and focus on alleviating the economic burden of catastrophic disease patients.