Abstract
This paper aims to explore the application of the fuzzy comprehensive evaluation method in the evaluation of the medical and health system reform by establishing an evaluation index system. Index weights were determined by means of factor analysis and analytic hierarchy process (AHP), while fuzzy membership functions were used to determine the subordination grades of the evaluated objects on different indexes. Based on that, the fuzzy comprehensive evaluation results and comprehensive scores of 31 provinces, municipalities and autonomous regions in different subordination levels in China were obtained by constructing Multi-level Comprehensive Evaluation Model. The results indicated that the effect of the reform of the medical and health system was relevant to local economic development level to some extent, while both commonalities and differences exist in the results of comprehensive evaluation performance among different regions. To improve the performance of the medical and health system, practical and feasible reform measures need to be put forward based on local realities.
Highlights
IntroductionChina's medical reform program, aiming at addressing difficulties and high expense in medical care, has realized institutionally full coverage of the whole population by the basic medical insurance through increasing the government's input into the healthcare and adhering to the principle of "giving subsidies to both supply and demand sides", with the new rural cooperative medical system (NCMS) even integrated with the medical insurance for urban residents (MIUR) in some areas
As of 2018, the new medical reform has been in progress for nine years
The following results are obtained according to the fuzzy comprehensive evaluations of the effect of the medical and health system reform in 31 provinces, autonomous regions and municipalities in China
Summary
China's medical reform program, aiming at addressing difficulties and high expense in medical care, has realized institutionally full coverage of the whole population by the basic medical insurance through increasing the government's input into the healthcare and adhering to the principle of "giving subsidies to both supply and demand sides", with the new rural cooperative medical system (NCMS) even integrated with the medical insurance for urban residents (MIUR) in some areas. Statistics show that the proportion of public financing in China's total health expenditure has increased from 49.1% in 2008 to 65.8% in 2013. With reforms of the supply and demand sides advancing continuously, the effect of the implemented reform of the medical and health system and the fact whether the reform addresses the problems in accessing medical care for and reducing the medical burden of the masses have become key issues deserving attention
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