Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (8): 120-126.doi: 10.6040/j.issn.1671-7554.0.2022.0274

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Analysis on use of medical insurance fund of compact medical community in Shandong Province

SHAN Ying1,2, ZHAO Yang1,2, LI Cheng1,2, LI Shixue1,2   

  1. 1. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. NHC Key Lab of Health Economics and Policy Research(Shandong University), Jinan 250012, Shandong, China
  • Published:2022-07-27

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Abstract: Objective To analyze the use of medical insurance fund of compact medical community in Shandong Province based on time and space perspective. Methods Based on data from the Medical Community Pilot Information Monitoring Platform of the Health Commission, and with medical insurance fund expenditures, medical insurance fund flow, outpatient expenses and hospitalization expenses as indicators, descriptive analysisand comparative analysis were conducted on the use of pilot medical insurance fund. Results From 2018 to 2020, the total expenditure increased year by year, the expenditure rate within counties increased, and the grassroots expenditure accounted for a relatively low and declining trend. The average outpatient expenditure increased year by year, but the average hospitalized expenses decreased. The development of regions was uneven, and the eastern regions had obvious advantages over the central and western regions. Conclusion A scientific and reasonable medical insurance fund payment mechanism should be established to promote the implementation of hierarchical diagnosis and treatment. The reform of medical insurance payment methods should be accelerated to reduce the personal burden of patients effectively. The leading role of government should be clarified to strengthen the overall planning and balanced development among regions.

Key words: Merged county medical alliance, Medical insurance payment method, Medical insurance fund, Shandong

CLC Number: 

  • R197.1
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