China’s hospitalization rates continue to rise, with the hospitalization rates for employees’ medical insurance and residents’ medical insurance reaching 21.86% and 20.7% respectively in 2023, far above the international average. This phenomenon is influenced by various factors, leading to significant pressure on China’s medical insurance fund.
Recently, “First Financial” reported on October 8th that according to data released by the National Medical Insurance Administration, the hospitalization rate for employees’ medical insurance in China reached 21.86% in 2023, while residents’ medical insurance reached 20.7%. The “2023 China Health Development Statistics Bulletin” shows that in 2023, the number of inpatients in medical and health institutions nationwide reached 301.873 million, an increase of 55.011 million from the previous year, with a resident annual hospitalization rate of 21.4%.
In 2003, the hospitalization rate under employees’ medical insurance in China was only 4.7%. Over the next twenty years, it has skyrocketed to its current level, with hospitalization rates in individual cities or regions surpassing 30% and even higher.
In contrast, the international average hospitalization rate is only 12%-15% and has been declining annually. An academic, after comparing relevant data, bluntly stated that compared with OECD countries, China has the fastest-growing hospitalization rate.
Local medical insurance officials have observed that the rapid increase in hospitalization rates may be considered as “abnormal elevation.” A former official of a coastal province’s medical insurance bureau stated, “The rising hospitalization rate will have a significant impact on the medical insurance fund.” Another employee of a city’s medical insurance department put it more bluntly, “Such a high hospitalization rate, the medical insurance fund can’t bear it.”
Regarding the reasons behind the high hospitalization rate, a medical insurance official named Du Lei believes that “DRG/DIP reform is the main reason for the increase in hospitalization rates.” He mentioned that in order for hospitals not to lose money, it is crucial to reduce the average cost per case. By lowering admission standards and breaking down hospital stays, this objective can be achieved, resulting in an increase in hospitalization rates. Additionally, the addition of a large number of beds incentivizes hospitals to lower admission criteria, treating minor illnesses as serious and admitting a large number of patients for hospitalization.