The Present Situation And Countermeasures Research Of New-type Rural Cooperative Medical System Of Jilin Province

BackgroundThe New-type Rural Cooperative Medical System(NRCMS) started a pilot insome county (city)Since2003,The central government treated Jilin Province as one ofthe first batch of4pilot provinces according to the difference of the economic andsocial development.Since the development of NRCMS,Jilin province has been activelyexploring in terms of program design, system construction and execution andachieved remarkable results. such as the coverage of NRCMS has been extended, theparticipation rate has been increased, the system continues to be consolidated andimproved, greatly improving the farmers’ medical conditions,reducing the medicalburden of participating farmers. But there are still many problems in the process ofimplementation of the NCMS,in order to give development situation of NRCMS ofJilin province a objective,real,comprehensive,impartial evaluation,it is argent problemto find out the existing problems and put forward countermeasures and suggestions toimprove the NRCMS of Jilin Province.ObjectiveTo evaluate the current situation of the development of NRCMS and analyzeexisting problems,and Propose useful countermeasures and suggestions to promotethe NRCMS development in Jilin province.This paper used horizontal comparisonresearch of the NRCMS data between Jilin province and the national and longitudinalcomparison research of the NRCMS data of Jilin province in recent years,and learnedfrom the experience of other countries rural medical security system and domesticNCMS in typical regional.MethodsThis study collected related reports and the system policies about the NRCMS ofJilin province,and referred to The Chinese Health Statistics Yearbook and National Economic and Social Development Statistics Bulletin,Jilin Province from2007to2012.To conduct a comprehensive analysis and evaluation about health resourcessituation,fund operation and agency construction and so on,and to put forwardcountermeasures and suggestions aiming at related problems existing the NRCMSdevelopment.Results1.Per capita health resources in Jilin Province continued to grow.From2007to2012,every1000people had beds and health technical personnel of medicalinstitutions all maintained a growth trend in Jilin Province,which higher than thenational average over the same period,but presented uneven distribution of healthresources between urban and rural areas.2.The NRCMS had achieved remarkable achievement since its development. Thenumber to participate in the NRCMS increased from10.468million to10.468million,the participation rate increased from82.1%to99.4%,the total financingincreased from536.565million yuan to3.86billion yuan,the per capita fundingincreased from51.3yuan to290.6yuan but lower than the national average level overthe same period.The outpatient and inpatient actual compensation ratio,thecompensation cap line had improved significantly.In2012,the outpatient and inpatientactual compensation ratio was37.0%and52.5%,respectively,which respectivelyincreased by15.3%and15.3%than in2007,but lower than the national average levelover the same period.the compensation cap line increased from30000yuan in2007to80000yuan in2012,the individual area reached100000yuan.3.The participating number that each actual staff manages in the county agencywas larger,and there was a big gap between regions.In2011,the average participatingnumber that each actual staff manages in the county agency was24112.1in Jilinprovince,the largest number was140651in YuShu city,which was111.4times of thesmallest number of1263in Jilin city.4.The patients who participating in the NRCMS spent the higher cost ofhospitalization in medical institutions above the county level.In2012,the average hospitalization expenses was10009.1yuan,the average pocket expenses was5686.2yuan,which accounted for66.1%of the per capita net income of farmers.5.The proportion that patients who participating in the NRCMS chose the countylevel and above medical institutions to the hospital continued to decline.From2007to2012,The proportion of county-level medical institutions inpatients accounting for thetotal inpatients increased from45.6%to54.1%,and medical institutions above thecounty level increased from18.4%to30.4%,township-level medical institutionsdeclined from36.0%to15.5%.Conclusions1.The NRCMS ran smoothly and had achieved remarkable achievement sinceits launch in Jilin province,but there were also some problems.Firstly,the fund-raisingcriteria was not scientific and the financing channels were too single.Secondly,thefund use lacked of a reasonable budget.Thirdly,the outpatient co-ordinatedevelopment was to slow.Fourthly,the number of the county agency staffing wasunreasonable.Finally,the hospitalized flow was not reasonable,and this trend wasincreasing year by year.