The Policy Effect of China’s Medical and Health System Reform：Based on the Investigation of Pilot Comprehensive Medical Reform

Abstract

Comprehensive medical reform is important to explore the medical and health system reform. It is the main direction of deepening medical reform, which is a powerful driving force for building a healthy China. This paper uses the data of the China Family Panel Studies （CFPS） 2010, 2012, 2014 and 2018, and treats the provinces in the pilot comprehensive medical reform as the treatment group and the remaining provinces as the control group. The DID method is used to examine the impact of comprehensive health care reform on residents’ medical treatment satisfaction, medical level acceptance and medical expenditures.Firstly, this paper cuts from the two perspectives of residents’ medical treatment satisfaction and medical level acceptance. It is more authentic and purposeful to investigate from the individual’s intuitive perception of medical conditions and medical services. Secondly, this paper cuts from the perspective of medical expenditures, and examines the annual medical expenditures of residents （absolute medical expenditures）, annual medical expenditures excluding reimbursements （absolute out-of-pocket medical expenditures）, the ratio of medical expenditures to family expenditures （relative medical expenditures）, the ratio of out-of-pocket medical expenditures to family expenditures （relative out-of-pocket medical expenditures）, and the ratio of out-of-pocket medical expenditures to medical expenditures （the ratio of out-of-pocket expenditures）, among which residents’ personal medical expenditures include hospitalization expenditures and injury and illness expenditures （non-hospital expenditures）.It is found that the comprehensive medical reform has significantly increased residents’ medical treatment satisfaction and medical level acceptance. Although the comprehensive medical reform fails to reduce residents’ absolute medical expenditures and absolute out-of-pocket medical expenditures, it significantly reduces relative medical expenditures and relative out-of-pocket medical expenditures. Further research finds that the comprehensive medical reform mainly reduces hospitalization expenditures, but it fails to reduce injury and illness expenditures in medical expenditures; from the perspective of self-paid ratio, the comprehensive medical reform significantly reduces the proportion of residents’ out-of-pocket expenditures; compared with rural areas, the policy effect of comprehensive medical reform in urban areas is more obvious. In general, the comprehensive medical reform has significant policy effects in many aspects, which has relatively reduced the burden of residents’ medical expenditures, but it has failed to directly reduce residents’ medical expenditures.