Fairness and Efficiency of Medical Services&#x02014;&#x02014;An Analysis of Hospitalization Cost Differences for Basic Medical Insurance Patients Based on Hospital Operation Efficiency

doi:10.19546/j.issn.1674-3830.2025.2.012

China Health Insurance ›› 2025, Vol. 0 ›› Issue (2) : 91-97. DOI: 10.19546/j.issn.1674-3830.2025.2.012

Fairness and Efficiency of Medical Services——An Analysis of Hospitalization Cost Differences for Basic Medical Insurance Patients Based on Hospital Operation Efficiency

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Abstract

Objective: The paper explores the impact of hospital operation efficiency on the disparity in hospitalization costs among patients with different types of basic medical insurance, and analyzes the relationship between efficiency improvement and the equity of hospitalization costs. Methods: Data were collected from 300 hospitals in Inner Mongolia in 2020, and data envelopment analysis was employed to measure hospital operation efficiency. A stratified random sampling method was used to select 22 hospitals. Patient hospitalization data were analyzed with a linear regression model to explore the relationship between hospitalization costs, hospital efficiency, and types of medical insurance. Results: The average operation efficiency of hospitals in 2020 was 0.4015, with an overall effective rate of 6.33%. For every increase of 0.1 in hospital operation efficiency, the average hospitalization cost of basic medical insurance patients will increase by 2.39%. The per capita hospitalization cost of urban and rural residents' medical insurance patients increase relatively higher, and the gap between the per capita hospitalization cost of urban and rural residents' medical insurance patients and employees' medical insurance patients decrease by 4.07%. Conclusion: Enhancing hospital operation efficiency can effectively narrow the gap in hospitalization costs between patients with different types of basic medical insurance, thereby promoting the equity of medical expenses. However, this improvement in equity is accompanied by a significant increase in hospitalization costs for residents, which may lead to an increased economic burden. It is recommended to strengthen the security of urban and rural residents' medical insurance, refine the multi-level healthcare security system, optimize the allocation of medical resources, and improve the cost supervision mechanism to ensure that the enhancement of hospital efficiency does not affect patients' economic burdens and access to medical care.

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hospital efficiency / hospitalization costs / type of medical insurance / healthcare equity

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Fairness and Efficiency of Medical Services——An Analysis of Hospitalization Cost Differences for Basic Medical Insurance Patients Based on Hospital Operation Efficiency[J]. China Health Insurance. 2025, 0(2): 91-97 https://doi.org/10.19546/j.issn.1674-3830.2025.2.012

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