The Problems And Countermeasures Of Medical Assistance For The Urban Poor People In Guangzhou

In aecess to healthcare serviees,the Urban Poor is not only restricted by its own economic conditions,but also discriminated by the social system,Which makes the poor trapped in the vicious cycle of Poverty due to illness,disease due to Poverty.It adversely affects the individuals and families'survival, even the rapid development of the country.Medical assistance system for poor people as a basic medical insurance system is a complement of the basic social medical system. Improve the urban poor medical assistance system, promoting chinese socialization process of medical assistance to address the poor people's medical problem has far-reaching and important.Beginning with the policy background of the national medical insurance,combining the theory of poor medical assistance and basing on literature search and expert advice, this study makes the survey program of medical assistance, and selects the Chinese developed cities Guangzhou as the practical investigated location. By questionnaire survey, case interviews and other methods form, it comparatively analyzes the medical assistance system'changement over the years in Guangzhou from several aspects such as the target, content, standards, methods, service providers and so on. And analyze the poor's basic situation, health service needs, demand and utilization, actual utilization of medical assistance. What's more, according to the use of Statistics methods single factor and multivariate Logistic regression analysis, it studies the urban poor medical assistance issue in Guangzhou comprehensively.Studies have shown that:Firstly, As the lowest level product of public health services, medical assistance has the similar health economic characteristics of the basic medical services. However, it is different from the reciprocity of health insurance's rights and obligations. Secondly, the system basically copes with the health care system in the same period, gradually expands the scope and content of medical assistance targets, and improves its standards and operability continuously. As a whole, it improves the poor's capabilities of using medical services, and in some way alleviates the poor's economic risks of disease. Thirdly,medical assistance of Guangzhou can combine the characteristics of the economy and the disease of the poor and use the method of the poverty line extrapolation and targeting to expand the scope of relief object, but object indentification and publicity ect basic work has not yet put in place, leading to the poor at the low knowledge level of medical assistance.Fourthly,the general population has higher income, higher levels of education and higher health services utilization / demand rate than the poor.The poor are poor health, and have high two-week medical treatment and hospitalization rate, as well as high demand of health services. Though its basic medical insurance coverage rate is high, low economic level makes it difficult to cross the threshold of medical insurance, it needs medical assistance to help to improve its health services accessibility.In fact, the use of outpatient basic medical assistance of the poor is generally inadequate, which is mainly related to the basic medical fund management that can not be accumulated on a monthly basis using. The major disease hospital pay rates of the poor is low, but efficient use of relief funds is not high. According to the basic medical insurance for urban residents with the poor medical care after hospitalization, beneficiaries'pay rate has increased sharply, leading to the number of Medicaid beneficiaries significantly becoming less.It further analyzes the influence of the poor's Medicaid use, we can easily discover that there are five significant factors that affect the use of Medicaid services, namely, Medicaid object's perceived health status, two-week sick or not, knowledge level of the Medicaid policy ,ease of medical aid use and working situation.Fifthly, the medical system in Guangzhou lacks of overall management , coordination and channels of the organic connection between the relevant departments, so that it affects the efficiency of medical assistance and the use of limited medical assistance funds. According to the survey data and implications about foreign countries'medical assistance, Guangzhou should draw lessons from foreign countries by paying more attention to the government medical assistance fund-raising, community-based first diagnosed, preventive health care and medical assistance should adjust to the changes of health care system in order to improve the medical assistance system and control rising health care costs. And establishes an urban-rural integration and sustainable medical assistance model from several aspects, such as the channels of medical fund-raising, service delivery, the method of compensation, the interface of the related medical assistance policies and departments, in order to improve the medical aid system of the urban poor in Guangzhou furtherly.