Study On The Mechanism Of Rural Health Resources On Disease Economic Risk

[Objective] In the "post-2020" period,it is necessary to further optimize and enhance the allocation and utilization of rural health resources to resolve the disease economic risks of rural vulnerable groups.This study analyzed the mechanism of rural health resources on disease economic risk by combining quantitative and qualitative research,so as to provide evidence for optimizing the allocation and utilization of rural health resources for resolving disease economic risk,and provide suggestions for promoting the formation of a long-term mechanism for resolving disease economic risk.[Methods](1)At the theoretical level,the research identified the research issues through the feasible capacity theory and the multi-dimensional poverty theory,and constructed the overall analysis framework of "Province-grass-roots-farmers-typical cases" according to the social deprivation theory.(2)At the provincial level,according to the open database,the overall allocation of social resources and health resources is evaluated by using factor analysis and entropy health resource allocation index,and the relationship between health resources and disease economic risk is preliminarily explored by using correlation and multi-level regression analysis methods.(3)At the grass-roots level,according to the functions of township health centers,this paper constructs an analytical framework for the study.The current(catastrophic health expenditure)and future(disease economic vulnerability)disease economic risks of farmers within the jurisdiction of township health centers were assessed by questionnaire,as well as the health resource allocation of township health centers where farmers are located.Structural equation was used to analyze the mechanism of health resources of township health centers on disease economic risk of farmers in their jurisdiction.(4)At the level of farmers,the analysis framework is constructed according to the theory of health poverty and the theory of resilience.Questionnaire survey was used to obtain the relevant data of farmers’ health resource satisfaction and perception,and structural equation and regression analysis were used to verify.(5)At the level of typical cases,semi-structured interviews were conducted with selected farmers with health problems through case study method to analyze the economic burden of disease and the demand for health resources of different types of farmers.Based on the grounded theory,this paper analyzes the mechanism of the integration of county health resources in typical farmer areas on the economic burden of farmer visits and the economic risk of disease.[Results](1)In the provincial analysis,it is found that the broad social resources at the provincial level are significantly correlated with the incidence of poverty by using public data(β=-0.6,p<0.05).There was also a significant negative correlation between health resources and disease economic risk(OR=0.51,p<0.01).(2)In the grass-roots analysis,township health centers with more abundant health resources have lower disease treatment and management ability,and the disease treatment ability can alleviate the current disease economic risk of farmers(β=-0.17,p<0.01),and the effect of disease management ability on the current situation of farmers(β=-0.11,p>0.05)and the future(β= 0.12,p>0.05).(3)In the analysis of farmers,for the common and frequently occurring families,the failure of health resources to meet the demand will cause the loss of farmers’ health level(β= 0.28,p<0.05)and the significant increase of the overall health economic burden of the family(β=0.72,p<0.05),and the health level of the family(β=-0.08,p>0.05)and the economic burden of the family(β= 0.02,p>0.05)has no significant effect on the current disease economic risk of farmers,and the health loss will significantly increase the future disease economic risk of families(β= 0.53,p<0.01).And the health loss of patients in the families of patients with major diseases(β= 0.22,p<0.05)and economic burden(β= 0.61,p<0.01)will significantly increase the economic risk of future family diseases.At the level of horizontal comparison of farmers’ perceptions,farmers’ perceptions of dissatisfaction with health resources at township and county levels will have an adverse impact on perceived health improvement and perceived family economic burden,as well as on township level(β= 0.17,p<0.01)and county level(β= 0.31,p<0.01)the perception of health improvement will have a significant impact on "unreasonable visit intention",while the relief of visit economic burden has no significant effect on visit intention,and the same results are obtained by longitudinal comparison."Unreasonable visit intention" affects the current situation of the family through unreasonable visit behavior(β= 0.03,p<0.01)and future(β= 0.01,p<0.01)economic risk of disease.(4)In the analysis of typical cases,families of patients with major diseases should take into account the cost burden and ensure their health ability,while families with common chronic diseases should focus on the availability of resources to ensure their health ability to avoid the deterioration of the disease.The integration of regional health resources based on system design,structure optimization and organization remodeling has promoted the sinking of high-quality health resources,improved the service capacity of grass-roots health institutions,promoted the formation of an orderly medical order,and thus resolved the economic burden of disease on farmers.However,the allocation of health resources with "disease treatment as the center" makes the disease management capacity of institutions and the special service capacity for special populations insufficient,which is not conducive to the continuous resolution of economic risks of diseases.[Conclusion](1)The study found that there is a certain degree of disharmony between "cost control" and "health protection" of health resources supply for vulnerable people in rural areas at this stage.Based on this,the study believes that diversified and coordinated health resources investment can promote the consideration of "cost control" and "health protection".(2)Farmers’ sense of access to and satisfaction with health resources also indirectly affect farmers’ economic risk of disease.In the future,it is necessary to innovate the use of health resources to promote fair access to high-quality services,so as to enhance the endogenous motivation of vulnerable farmers.(3)The uneven allocation of health resources for "treatment" and "prevention" has affected the effect of resolving the economic risks of diseases among farmers.Therefore,it is necessary to give consideration to the investment and utilization of health resources for "treatment" and "prevention" to comprehensively prevent the current and future economic risks of diseases.(4)People with different diseases have diverse health resource needs.It is necessary to accurately identify vulnerable people and provide health resources suitable for their families’ comprehensive development ability,and implement classified policies to accurately meet the different needs of families.(5)The orientation of health resource integration will affect the economic risk of disease of farmers.It is necessary to promote the reform of health resource integration with "great health" orientation and system design,optimize the design of organizational system and promote the allocation of characteristic health resources,so as to promote the comprehensive service capacity of the region.