Study Of Multi-channel Financing Of CHS In Chengdu

Objective: To learn of the condition of charge and source of financing in CHS, and to find the influential factors as well as the shortcomings, in order to provide suggestions on improving the condition. To learn of the condition of government financing on CHS, and to study the specific methods of government financing and policies on health center surroundings and services items. To learn of the condition incorporating CHS into social medical insurance system, and to explore the methods of increasing the financing on CHS from social medical insurance. To learn of the other financing channels for CHS and to make reasonable suggestions.Method: 20 CHS centers from Wuhou district and Jinjiang district in Chengdu were selected for questionnaire survey to learn of the financing condition of CHS. According to different economic status, a total of 420 residents from such 3 communities as Shuangnan community, Yulin community and South Station community (each 140 persons) were sampled randomly for a questionnaire survey. 18 experts from health bureau, finance bureau, civil bureau, social insurance bureau, street agency, commercial medical insurance company and community health center were interviewed deep face to face to learn of their opinions on different financing channels for CHS, and to summarize the advices on multi-channel financing suitable for CHS development.Results: Medication and medicine income is the main economic source of community health center, which amounts to 90% of total income. 6.45% of total income comes from government financing. Money from beneficial population because of carrying out public health services amounts to 2.57%. Income from outpatient services amounts to 0.48%. from Social Medical Insurance amounts to 0.63%; from social donate, collectivity financing*, salvation of fund, etc. amounts to 0.25% o141 from 414 investigatees which amounts to 34.1% learn of the CHS. But only 8.9% chooses community health center for medication firstly. Logistic regression analysis shows that such factors as price, attitude of doctors and services styles influence whether the residents choose community health center for medication.Only 4 out of the 20 CHS centers get specific financing for start from financial department, with different standards. No compensation were got for houses and management information net system. Cultivation work of community health talents has been developed by two district health bureaus.6 CHSC amounting to 30% obtained the services compensation from government.240 persons out of 414 residents investigated attend social assurance, amounting to 58%.16 CHS centers are incorporated into appointed social medical insurance facilities, and either of the two districts has 8 centers. The incorporation rate is 80%.Most CHS items can not be paid through social insurance finance.165 residents investigated suffer from chronic diseases, 39 of whom need tending during the acute period, 13 of whom need tending at any time. With the hypothesis that expense of instituting hospital at home could be written off though social insurance finance, 63 persons hope to instituting hospital at home.Conclusion: Services charges are still the main channel of CHS. Community residents lack of understanding of CHS and the competition in medical services market influence the financing of CHS. Price, attitude of doctors and style of services affect the utilization of CHS by those who know it.Government has insufficient and unstable investment on CHS. Investment on CHS items increases to some extent, but uniform standard is lacked, structure and style of investment need improving, and utilization of specific finance is lack of supervision.Medical insurance system spreads widely in cities, which provide a basis for CHS utilizing Essential Medical Insurance. Demand for treating chronic diseases in community and for instituting hospital at home among community residents is high. To incorporate CHS into Essential Medical Insurance system, money and staff problem need solving, and management need improving. Sustainment to CHS from essential medical insurance system has not standed out. Such channels as commercial medical insurance finance, community finance, social donate, project finance, salvation of fund, etc, still contribute little, and the latent capacity has not been excavated efficiently.