Affectts Of Health Service To New Rural Cooperative Medical System

Objective:in oder to study the difference of new rural cooperative system(NRCMS) designing between city and rural area,we compared countryman's health service need,using between city and rural.Methods:We selected the exhibition new rural cooperation medical experimental units of TAIYUAN city district(YINGZE area,WANBAILIN area,XINGHUALING and JIANCAOPING area)and village(LOUFAN county),make use of the household health service survey,collect the data of farmer's health service need and use,compared the characteristics of health service needs and use between city and village area;We collected the farmer hospitalization experience.Under the principle of "collect money as pay",we measure pure insurance fee for big disease orchestration,combining the city country farmer health service need and use characteristics,we announced to public the important point and main difference of the system designing.Results:The difference of social economic environment between city and country is dissimilarity,the social population characteristic are difference too;The difference of farmer health service needs between city and country are significant,comparing to city area,farmer bi-week disease prevalence rate is higher in LOUFAN county,and chronic disease prevalence rate is so as that too(P＜0.001),the days of bi-week disease sufferer lies on bed are more than that in city(P＜0.001).Village residents' both out-patient service and hospitalization service utilization are higher,the class of seeking medical advice is lower,the average out-patient service expenses is higher than those in city,but the hospitalization expense is lower than it;The P2.5 and the P97.5 value of hospitalization fee are similar between city and country.taking NRCMS' target as "farmer's pays to hospitalization fee will not exceed the annual income 200%, and to stop payment at 20,000 RMB",we calculated as 95,23 and 49 RMB respectively at LOUFAN,WANBAILIN AND YINGZE area.Conclusions:The lower of social economy development level,the more of farmer health service need,NRCMS should be with" big disease orchestration is lord,look after both sides the small illness out-patient service" in lower development area,but taking county as the basic unit in this kind area,NRCMS' ability to resist big disease risk would be lower;The farmer in city area health service demand quantity is lower,whose income level is higher,whose resisting big disease risk ability is stronger.we suggest that NRCMS should be taken planning at the region bigger more than county and less than province.