Urumqi San-gong Community Health Service Integrate With Medicine Guarantees Policy Effect Appraisal

"Too hard and too expensive to see a doctor" has become a hot social issue recently, under widespread concern.Could the patient flow be diverted into health care facilities on community level,the gross national saving in health expenditure in town could amount to RMBï¿¥200 billion.Similarly,the World Health Organization has acknowledged that,over 80%of inhabitants' health need should be satisfied in community,the basic health facility and the basic health insurance share the common subject to serve:people in social groups.Purpose:The San-gong Community took the lead in 2006 to implement the policy of integrated management of unified accounting in the community health center and community clinics under its jurisdiction.However,the results of this policy haven't become clear yet.This research carries out analysis from three aspects:the policy's influence on health customers' demand and use of health service,the effect on the community health center's outpatient quantity and its fund raising,and the reduction in health service and insurance expenditure.Also,we surveyed the attitudes of people in health insurance plan towards health insurance's inclusion of community health service,to provide evidence for reference of local community health service and insurance institution's development.Content:to analyze the effect of the combination of the city health insurance and the community health service on the solution of fund raising for community clinics;to investigate the influence of relevant policies,especially the economic compensation policy,on inhabitants' use and demand of health service;to see if patient flow has been reasonably diverted;to observe changes, if any,in community clinic patients' characteristics before and after the health insurance reform;to analyze the brake effect of policies on health expenditure increase;and to probe the probability of other community health service items to be covered by health insurance.methods:with the community health center,its subordinate and superior (transfer-to) health facilities,and community inhabitants being served,as research subjects,through collection of indirect information,key person interview,questionnaire survey,typical case analysis,and logistic regression,to carry out static and dynamic analysis on the resultant effect from policies on health insurance's inclusion of community health service.Policy suggestions:The market of community health service remains to be expanded;The quality of community health service remains to be improved,diagnose and treatment techniques to be upgraded;The institution of reciprocal transfer of patients waits to be built and improved; Health insurance management of community health service needs to be strengthened and completed;The expenditure saving mechanism in community health service needs further consolidation.