A Study On The Effect Evaluation Of Military Employee's Health Service Reform In Xi'an Region

Military employee is a part of military member, and is also a part of national employee. Reform of military employee's health service is an important part of military medical security institution. It reflects the safeguard of the benefits of military employee health. It has very important significance for improving medical security level and safeguarding military employee health. State Council issued"Decision of establishing city work basic medical insurance"in 1998 and issued"notice about relative questions of promoting the socialization of military logistic security by military command and State Council"in 2002, in which clearly showed that employees in military office and facility unit should take part in medical insurance in local society. This decision is the inevitable demand for establishing society security institution and promoting military employee management system reform. To take part in society medical insurance, military employee can accumulate some medical funds during work time. When they leave army, they can get consecutive medical security without worry. Aim: to understand policy, step and its relation to object of military employee medical security institution reform. Investigate the situation about military employee taking part in society medical insurance in Xi'an region, study the questions, shortage, affect factor and give proposition, provide basis to improving military employee medical security institution reform.Method: 1 understand the background and situation of military employee medical security institution reform by studying reference.2 understand the basic circumstance of military employee medical insurance by pre-investigating some chosen military employee in local region, 3 layer random sample was used to make inquiring investigation to chosen employee. Excel 2003 software was used to take in primary data; SPSS13.0 software was used to make statistical analysis.4 compare analysis was used before and after reform to make comprehensive evaluation about behavior of seeking medical advice, composition of funds, expenditure, drug use, quality of medical service, convenience, content by military employee.Result:1 Behavior of seeking medical advice: after reform, 72.4% of military employee chose to go to fixed point hospital, 91.6% hospitals were two-grade hospital, and good service could be provided. The main reason to choose is near and good quality, 42.5% and 36.1% respectively. Statistical difference is between different kinds of people(P < 0.05).Most employees recognized that the quality is good. Less employee overdone during drug use and hospitalization, only take 3.4% and 4.3%. 84.7% employees did not see doctor when they got diseases, which is higher than national proportion 84.7%. Among them, 41.1% employees thought they had no needs to go to hospital, 35.4% works have no money to go to hospital. 77.4% employees bought drugs outside of hospital, which is higher than the national proportion 36%. 74.7% employees have no money to go to hospital, which is higher than national proportion 70.0%.2 Expenditure composition and drugs usage: out patient cost is between 50 to 100 yuan in average. Compared before reform, 44.3% employees thought the expend is increasing, Outpatient cost is between 100 and 2000 in average in a year, drug fee and examine fee are the main proportion, taken 51.1% and 37.7% respectively. Compare before reform, 27.9% employees thought that drug overuse had not been controlled after reform. 50.0% employees thought that reasonable use of drug had not been controlled, 45.8% employees thought drug level had not been changed, 33.8% employees thought the catalog of drug is unreasonable, comprehensive content was not high by employees after reform. Inpatient cost is between 1000 and 5000 in average at one time. 52.4% employees thought the cost is increasing. Drug fee, examine fee and treatment fee are the main proportion, taken 33.1%,26.6% and 29.0% respectively. Personal cost is between 500 and 2000, 83.1% employees thought they were overburden. The main reasons are overused precious drug and overused instrument examination.3 Quality of medical service and convenience: 84.5% employees content about the service, 71.7% employees thought the hospital is near and not far, 59.6% employees thought the program of using medical card is too complex. 40.9%,61.9% and 78.8% employees thought drug use, special examination and medical cost are not reasonable. 86.8%,90.9% and 89.3% employees content with desk person, doctor and nurse, comprehensive contents is high to medical employees. 4 Comprehensive contents between different units: 61.9% employees were totally recognized that it was reasonable to take part in local medical insurance, 16.0% employees recognized the medical security was improving after reform, statistical difference is between different kinds of people(P < 0.05). The proportion in Air Force Technology University and the No.28 Company of logistics was 15.5% and 25.9% respectively, which was higher than 5.7% in the Fourth Military Medical University. 29.7% employees thought the medical security was decreased, statistical difference is between different kinds of people(P < 0.05). The proportion in Air Force Technology University and the No.28 Company of logistics was 17.7% and 19.3% respectively, which is lower than 41.0% in the Fourth Military Medical University, the reason is that the employee in the Fourth Military Medical University enjoyed the relatively high level of medical security before reform. 54.6% employees thought the medical service quality had not improved, the proportion of the totally consent to medical service after reform was 74.4% in each units.Conclusion:1 The achievements of medical security reform in Xi'an region:â‘ an new military employee medical security institution has been established.â‘¡the institution meets the needs of army work medical security.â‘¢it inhibit the excessive need of medical security in military employees.â‘£the contradiction between medical expenditure support and medical expenditure need has been solved.2 Problems remained in medical security reform in Xi'an region:â‘ the behavior change in the need part can affect the personal health level.â‘¡the medical insurance system is not perfect in a whole. The supplementary manner builds too slowly and can not satisfy the need of military employee medical insurance.â‘¢the behavior overdo in provide part can led to the quickly increase in medical expenditure, medical cost have not been reasonably controlled.â‘£the use of medical card is too complex, convenient way need to be improved.3 Proposition and strategy:â‘ develops the responsibility of government and army, solve the problem of military employees who have not enough money and improve personal health level.â‘¡builds multiple level of medical insurance system.â‘¢improve the reform of medical institution compensate system, improve the reform of medical and health system, and the drug making and drug currency system.â‘£sticks to the principle of seeing doctor conveniently and improve the efficiency of using medical card.