| The target level of funding of the new rural cooperative medical care is the level which under the established economic conditions, aim at reducing the economic burden caused by disease, improving the farmers' health level and solving the phenomena of "being into poverty by illness" and "returning in poverty by illness" etc., to reach a certain degree of safeguard projective. The target level of funding decided the required fund raised amount under the different safeguard objective. And combined with the possible funding level which was calculated by the factors such as farmers' economic level, objective ability to pay and willingness to pay, it drew up the new rural cooperative medical care funding level scientificly and reasonablely. The scientific and reasonable target level of funding calculate technology is the premise for the new rural cooperative medical system's sustainable development, which also has an important theoretical and practical significance in accelerating the new rural cooperative medical care system' health and sustainable development and safeguarding the vast rural people's health condotions.This study take 1007 samples by using the multi-phase-stratified-cluster sampling method ,In order to determine the survival line and the basic living needs line, this study reckoned the survey area's poverty line by using the Extended Linear Expenditure System, and then calculated the threshold of the economic risk for medical service. It measured the survey district's situation of "being into poverty by illness" by using the three indicators of it, analyzed the rural residents' economic risk for medical service by using the indicator of it and evaluated the new rural cooperative medical care's capability of relieving the " being into poverty by illness" phenomenon through the metrics of poverty caused by diseases before and after and the changing indicators of economic risk for medical service. Based on analysis and evaluation it designed different levels of safeguard objective, through the gap of poverty caused by illness index it reckoned the target level of funding under the corresponding safeguard objective, and ultimately determined the appropriate target level of funding.The calculation results of this study are: Sample area's survival line was 3644.689 yuan per capita, basic living needs lineâ…¡was 5389.322 yuan per capita, and the corresponding risk threshold lineâ… was 4755.31 yuan, the corresponding risk threshold lineâ…¡was 3010.68 yuan. Under the risk threshold lineâ… ,the incidence rate of poverty caused by illness was 3.59% , the Severity of poverty caused by illness was 62.37% and the depth index of poverty caused by illness was 0.43, under the risk threshold lineâ…¡, the incidence rate of poverty caused by illness was 4.34%, the Severity of poverty caused by illness was 63.47% and the depth index of poverty caused by illness was 0.69. In two weeks the out-patient rate was 9.23%, chronic disease out-patient rate was 8.91% and the annual hospitalization rate was 6.03%. The median value of out-patient's average cost in the sample area was 300 yuan, the median value of hospitalization's average cost was 6000 yuan. The distribution of the economic risk for medical service which was grouped according to cost had tremendous difference, the maximum RR value was 446.99 times of the minimum value and the out-patient value was 13.86 times of the hospitalization value. The distribution of the economic risk for medical service which was grouped according to income also had tremendous difference, the lowest income group of adjusted RR value was 98.36 times of the highest income group and the out-patient value was 15.68 times of the hospitalization value. After the new rural cooperative medical care system implemented in the sample area, under the risk threshold lineâ… , the incidence rate of poverty caused by illness dropped 58.23%, the Severity of poverty caused by illness decreased 60.22% and the depth index of poverty caused by illness fell 60.47%, under the risk threshold lineâ…¡, the incidence rate of poverty caused by illness dropped 35.71%, the Severity of poverty caused by illness decreased 48.12% and the depth index of poverty caused by illness fell 47.83%. According to the economic risk for medical service which was grouped by cost, it decreased 29.03% as a whole, the RR value of the out-patient number fell 12.53% and the hospitalization number dropped 31.67%.According to the economic risk for medical service which was grouped by income, it decreased 29.03% as a whole , the adjusted RR value of out-patient number fell 12.51% and the hospitalization number dropped 31.73%. Under the risk threshold lineâ… , the total funding goal of the completely model is 373794600 yuan, target level of funding per capita is 307.57 yuan, funding level of personal goals is 92.27 yuan. Under the risk threshold lineâ…¡, the total funding goal of the completely model is 380088900 yuan, target level of funding per capita is 312.75 yuan, funding level of personal goals is 93.83 yuan. The real funding level of per capita was 162.5 yuan and the individual funding level was 45 yuan.The conclusions of this study are: because the sample area had a higher economic level, the survival line and the basic living needs line there were above the national standard. The result of the poverty caused by illness index's calculation reflected that the severity of the poverty caused by illness was above normal. The indicator of economic risk for medical service reflected that the distribution of the economic risk for medical service had tremendous differences, and it mainly manifested in the following aspects: the economic risk for medical service in the high segment of medical care cost exceeded the risk in the low segment of medical care cost, the hospitalization's economic risk was higher than out-patient, the low income group's economic risk was above the high income group's, and all these indicated that the new rural cooperative medical care system should pay great attention on solving the high medical expenditure and the low income group's economic risk for medical service. The comparison of the new rural cooperative medical care system's implementation before and after manifested that the new rural cooperative medical care system's effect of ease the "being into poverty by illness" was obvious, and when came to the ease effect on economic risk for medical service, the hospitalization exceeded the out-patient. Combined with the calculated results under the four modes of the funding level it considered that the phenomena of "being into poverty by illness" and " returning in poverty by illness " in the sample area still can not be totally solved. But by combining the analysis of the residents' willingness to pay and the economic level, it's believed that improve the funding level is quite possible, and it can finally reach that target level of funding which can totally solve the"poverty caused by illness"phenomenon.
|
PDF Full Text Request