The impact of China's latest population policy changes on maternity insurance-a case study in Jiangsu Province.

This study aims to examine the impact of China's population policy changes on social insurance. Nearly 4 decades ago, China ushered in the 1-child policy as a family planning policy to control the adverse effect of high population growth. The current maternity insurance system in China is designed to fit the operations of the 1-child policy. However, the implementation of the comprehensive 2-child policy can pose a challenge to the sustainability of the current maternity insurance scheme hence the call for reform. The study empanels a novel and comprehensive system dynamic model that incorporates all the related factors that influence the income and expenditure of maternity insurance in the Jiangsu Province. Data are mainly derived from the historical data of the Statistical Yearbook of Jiangsu Province and the National Bureau of Statistics of China. These are used to construct and simulate a system dynamic model to determine a sustainable contribution rate for maternity insurance. In conclusion, if the rate of contribution of the current maternity insurance policy is not increased, the burden of implementing the comprehensive 2-child policy will exacerbate the current deficit balance of the maternity insurance fund. The existing maternity insurance benefits thus cannot be maintained, and women's health will be threatened. In the short term, the study proposes an increase in the rate of premium payment to prolong the life of the maternity insurance. In the long term, there is a need to improve the level of coordination and expand the coverage of maternity insurance.

Study on Comparison and Development of 2017 and 2009 Edition of Medicine List for National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance / 中国药房

OBJECTIVE:To provide reference for improving related policy and list about medical insurance medicines in China. METHODS:The descriptive analysis method was used to compare 2017 and 2009 edition of Medicine List for National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance in respects of item,medicine classification (including classification code,grading and name),medicine types(including new type,removed type),dosage(including new dosage classification,adjusted dosage form),the limit of payment and use.The trend of its development and the existing problems were discussed. RESULTS:Compared with 2009 edition,2017 edition of medicine list added the item of"drug classification code"and removed the item of"English name". The grading of drug classification code was reduced from six grades to four grades. The code and name of four grades classification were in accordance with the first four grades classification rules of the anatomical-therapeutic-chemistry(ATC). A total of 2 535 types were included in 2017 edition,increasing by 362 types compared to 2009 edition(151 chemical medicines,211 Chinese patent medicines). 15 types of chemical medicines were removed,and 4 types were transferred to Chinese patent medicine list;11 types of Chinese patent medicines were removed,and one type was transferred to chemical medicine list. 2017 edition was actually 20 more dosage forms than 2009 edition,involving 31 types;dosage forms of 231 types were adjusted(143 chemical medicines,88 Chinese patent medicines). Chemical medicines of usage and payment restriction increased from 239 to 302,and Chinese patent medicines increased from 72 to 115,respectively. CONCLUSIONS:2017 edition of list increases the number of medicine,expands the scope of clinical medication and improves the classification structure of the list.The number of medical insurance cost control type shows a growing trend.

Practice and Exploration of the Maternity Insurance Management Based on DRG / 中国卫生经济

Based on management ideas for DRG disease grouping,it targeted at comparing the differences and maternity insurance control status of different medical groups within the same disease,provided data support on internal standard practical medical treatment and effectively controlling expenses;based on data analysis,the communication with the medical insurance management department was improved to provide suggestion on further implementation for maternity insurance.

Effect of the new maternity insurance scheme on medical expenditures for caesarean delivery in Wuxi, China: a retrospective pre/post-reform case study.

Aiming to control rising medical expenditures and help improve China's healthcare systems, this study examined whether a cap-based medical insurance scheme with shared financial interest between the insurance and healthcare providers is effective in containing hospitals' C-section medical expenditures. We used 6547 caesarean delivery case records from a teaching tertiary-level general public hospital located in Wuxi, China (2004-2013), and used the Chow test to investigate the possibility of significant variation in mean medical expenditures for caesarean deliveries pre- and post-reform. We also used paired sample t-tests and linear regression models to compare the mean medical expenditures between insured and uninsured women undergoing caesarean delivery during the post-reform period. After the scheme's implementation, medical expenditures for caesarean deliveries declined and the medical expenditures of women covered by the scheme were significantly lower than those of uninsured patients. These findings indicated the scheme's effectiveness in minimizing caesarean delivery expenditures. The cap-based medical insurance scheme with shared financial interest between insurance and healthcare providers would likely steer healthcare providers' behaviors in a more cost-effective direction.

Study on the Effects of Maternity Insurance Capitation on Obstetric Index / 中国卫生经济

Objective: To study the effects of maternity insurance lump capitation on obstetric index in Yinchuan , discuss its impact on decreasing cesarean section rate and improving reasonable check and rational drug use. Methods: The relevant indexes of inpatient parturient in Yinchuan fixed-point hospitals in 2011 are analyzed by comparing with the data from 2008 to 2010. Results:After the application of capitation lump policy, the cesarean section rate of the research object decrease from 54.14% to 35.38%, average hospitalization expenditure decreased by 9.52%, per drug expenditure decreased to 45.24%, average length of stay decreased by 0.8 day and per medical service cost increased by 9.39%. Conclusion: Since the application of capitation lump mode, the effects on the indexes of cesarean section rate, medical and medicine cost are obvious.