Study On Status Evaluation Of The Issue Of Expensive Medical Service

Objectives: This paper is to systematically review and evaluate the status of the issue of expensive medical service centering on researches on macro-factors, micro-factors, subjective factors and objective factors and find out the projected problems and sticking points. Thus, theoretic basis can be provided for the government and related administration departments to formulate scientific and effective policies.Materials and Methods: Reviewed health cost associated statistical data published by WHO and China Ministry of Health. Choose stratified cluster random sampling method, carry out questionnaire survey in outpatient and inpatient cases of Hefei hospitals. Retrieved 1209 pieces of valid questionnaires in all. Then make descriptive statistics analysis, multivariate logistic regression analysis and linear regression analysis in order to find out the main factors affecting the issue of expensive medical service.Results: (1) The proportion of National total health expenditure among GDP, which is not too much high, is correspondent to the economic capability. During the 24 years from 1980 to 2003, the average flexibility index of total health expenditure to GDP is 1.37 and public raising funds accounting for only 36% in the total health expenditure ranked 162 in the world lagging far behind the average level of middle-level-income countries.(2)During the 10 years from 1993-2003, the average outpatient charge per time and the average inpatient charge per time have surpassed the increasing rate of the average income. The number of the sick people not seeing a doctor in urban area is higher than that in rural area and the number of the sick people not seeing a doctor among the low-level-income people is higher than that among the high-level-income people. 87.58% of the people receiving the survey recognize the existence of issue of expensive medical service. The majority of the people receiving the survey choose the hospital with provincial or civic level to see a doctor as the first priority, deeming the community medical service as a hard practice with low cost-effectiveness. Most of the people receiving the survey consider the existence of issue of expensive medical service mainly lies in the causes of high medicine and examination charges. What accounts the willingness to pay for the medical service depends on the level of education and the ownership of health security funds.Conclusion: According to the analysis from macro aspects, the fee-for-service is not so high. Recently, the rapidly increasing health expenses and the much higher the high level of self-paying medical charges for the lower level of public financing maybe the key objective factors for the issue of expensive medical service. According to the analysis on the utilization of the medical service among different regions and different groups, economic development can be found as the key factor to play a role. From the results from the on-the-spot survey, patients were less willing to pay for the medical charges by themselves. What accounts the willingness to pay for the medical service depends on three influential factors: the reasonable sense of medical consumption, the ownership of health security funds, the realization of the value of the health, among which the middle factor influences mostly.