title: Effects of New Rural Cooperative Medical Scheme on Medical Service Utilization and Medical Expense Control of Inpatients: A 3-year Empirical Study of Hainan Province in China.
abstract: BACKGROUND
  The New Rural Cooperative Medical Scheme (NCMS) has been further adjusted and optimized to reduce the financial burden of rural residents and to achieve universal coverage for them. In this study, we aimed to explore the impact of NCMS on medical service utilization and medical expense of inpatients in recent years.
  
  
  METHODS
  The research data of Hainan Province were extracted from the Chinese NCMS platform from 2012 to 2014. Detailed information included total expenditure, average inpatients costs, average out-of-pocket payments, actual reimbursement rate, and average annual growth rate of the above indicators. Descriptive analysis was used to gauge the effects of NCMS.
  
  
  RESULTS
  In the utilization of medical services, NCMS inpatients in tertiary hospital decreased from 25.49% in 2012 to 20.39% in 2014, inpatients in county hospitals increased from 39.49% to 55.92%, simultaneously. The total expenditure in county hospitals rose steadily from 28.46% to 46.66%, meanwhile, the total expenditure in tertiary hospitals fell from 60.44% to 44.51%.The average out-of-pocket costs of rural inpatients remained stable over the years. Furthermore, the compensation fund of NCMS inpatients grew significantly. The actual inpatient reimbursement rate at township health centers increased from 76.93% to 84.04%. Meanwhile, the rate at county hospitals and tertiary hospitals increased slightly from 59.37% and 46.10% to 61.25% and 47.71%, respectively.
  
  
  CONCLUSIONS
  With the improvement of the reimbursement ability, especially after the new health care reform in 2009, the NCMS have been playing a prominent role in alleviating the economic burden of farmers' medical treatment. Meanwhile, more patients go to primary hospitals than tertiary hospitals, and the capability of primary hospitals has been greatly improved.
authors.affiliation: Center for Health Policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Dai
authors.affiliation: Center for Health Policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China.
authors.forename: Hong-Pu
authors.initials: HP
authors.lastname: Hu
authors.affiliation: Center for Health Policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Na
authors.affiliation: Center for Health Policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China.
authors.forename: Ya-Zi
authors.initials: YZ
authors.lastname: Li
authors.affiliation: Center for Health Policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China.
authors.forename: Yan-Li
authors.initials: YL
authors.lastname: Wan
authors.affiliation: Center for Health Policy and Management, Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing 100020, China.
authors.forename: Li-Qin
authors.initials: LQ
authors.lastname: Xie
mesh_terms: D002681:China; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics; D008297:Male; D012424:Rural Population