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Enhancing Pooling Levels Strengthens The Risk Resilience Of Healthcare Insurance: A Case Study Of Basic Medical Insurance Fund Operations Data In Gansu, China.

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Enhancing Pooling Levels Strengthens The Risk Resilience Of Healthcare Insurance: A Case Study Of Basic Medical Insurance Fund Operations Data In Gansu, China.

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Enhancing pooling levels strengthens the risk resilience of healthcare insurance: a case study of basic medical

Feng Hu¹, Liu Heming¹, Cao Wenxuan¹

¹Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, 730000, Lanzhou, Gansu, China.

BMC Public Health

|April 23, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Keywords:

Basic Medical Insurance COVID-19 DEA model Enhancing pooling levels

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Enhancing health insurance pooling in China improved efficiency from 2020-2022, despite COVID-19 challenges. Increased pooling levels positively impacted basic health insurance operations and resilience.

Area of Science:

Health Services Research
Health Economics
Public Health Policy

Background:

China's basic health insurance system aims to improve healthcare access and financial protection.
Enhancing pooling levels is a key strategy for refining China's healthcare insurance system.
The COVID-19 pandemic introduced new challenges to basic health insurance operations from 2020 to 2022.

Purpose of the Study:

To assess the efficiency of basic health insurance in Gansu Province from 2020 to 2022.
To analyze the impact of pooling levels on health insurance efficiency.
To evaluate the operational performance of different health insurance pooling models.

Main Methods:

Data Envelopment Analysis (DEA) was employed to measure efficiency.

Malmquist index was used to assess changes in efficiency over time.

Fixed-effects panel Tobit models analyzed factors influencing operational efficiency.

Main Results:

Municipal pooling for urban and rural residents showed stable overall efficiency (0.941) with an expanding frontier.
Operational efficiency correlated negatively with per capita hospitalization expenses and positively with reimbursement rates.
Urban employee insurance efficiency varied, with county-pooling declining and municipal-coordinated pooling improving.

Conclusions:

Basic health insurance in Gansu Province demonstrated satisfactory operational performance from 2020 to 2022.
Increasing pooling levels is beneficial for health insurance system resilience against unforeseen events.
Strategic enhancement of pooling levels can strengthen China's healthcare insurance system.