A Research Of Government Purchasing Health Service In The Urban Community Endowment In China

Reform and opening is up to three decades. The Chinese economy is developing rapidly. The people's living standard is getting better and better and the average life expectancy continues to increase. But along with growing aging population in our country, it also brings a series of problems to be solved. Health service is an important issue in elderly care. To solve this problem is directly related to hundreds of millions of elderly health and family happiness of our country. At the same time, it is also related to social harmony and stability. The Party's18th congress put forward that "everyone is entitled to share the achievement of reform" as a strategic objective. Government purchasing the health service in community endowment will be an inevitable choice to achieve this goal.In the context of comprehensive deepening reform of our country, this thesis systematically studies the issues in the government purchasing health service in community endowment. The research achievement of the thesis provides the best profit for the transformation of government functions, decentralization and financial funds, good quality of health services for the elderly, positive response to population aging, important significance, to assist standardizing and pushing on the action of government purchasing the health service. It provides a reference for making the thirteenth five year plan and relative reform and decision making by the government.It mainly introduces the context and significance of the research to the government purchasing the health service in the community endowment and raises questions. In the background of rapid population aging in China, how to use the method of government purchasing the health service to respond the issue brought by the population aging is the key point of research by the thesis. On the basis of specific study to Government economics, New public management theory, Public health product theory and related content of Entrust agent theory, it analyzes directive significance of these theories to the research on the government purchasing the health services in the community endowment. From current situation, characteristic and issues of the Chinese population aging in addition to the pension reform history, it analyzes the achievement made and issues existing presently and studies the reform and development trend on urban community endowment in China. And then it points out that the community endowment is the main model in China. It evaluates the current situation of the reform of the government purchasing the health service in the urban community endowment in China and abroad. Based on the analysis of the development trend of the urban community health care system reform in China, it further analyzes the current situation of the government purchasing the health service in the urban community endowment and the existing main issues in China. It studies the community health care development and relevant experience of the economically developed countries such as The America, countries of Western Europe, Japan, Brazil and Russia in addition to countries of Eastern Europe and Cuba and points out its enlightenment to the government purchasing health service development of our country.It studies the necessity, purpose, principle, undertake body, content and mode of government purchasing health services in the urban community endowment in China. It discusses the necessity of the government purchasing the health service in the urban community endowment in China from the aspects of increasing requirement to the health service by elderly and the insufficient providing by the urban community health service organization. It further studies the purpose of government purchasing health service in order to benefit the people, improve the efficiency of the government fund utilization and promote the social forces to run health organizations. It thinks that the principle of government purchasing the health service in the community endowment in china should be fair and equitable, open and competent, scientific and standard, steady and orderly. It analyzes the current situation of the undertake bodies for the community health service and the key problems existing. It proposes using the scientific plan to lead the health organizations setting up, using the good policy to attract excellent medical staff working at basic level, using many ways to promote private health organizations growing and strengthen rapidly in order to develop vigorously the undertake bodies of the health service purchased by the government. It studies the content and mode of the health service purchased by the government in the community endowment in China. Its contents are mainly basic medical service, community health education, community disease prevention, community health service, psychological counseling and Chinese medical service etc. The main modes are the designated agency of medical insurance, sub-contractor, vouchers, authorization, free medicine, certification and training.On the basis of the discussion of the necessity to set up the model, it categorizes the items on government purchasing health service from breadth. Afterwards the estimation model of the total cost on government purchasing health service in urban community endowment in China is set up. It raises the government purchasing health service in community endowment to a theoretical level. The model is set up in order to direct each department of the government to practically operate the purchasing health service items in community endowment. It makes the limited funds to provide more and better health service to the elderly. At the same time, it usefully makes the government purchasing health service open and transparent. As an example in case of the government purchasing health service in the community endowment in a district of Beijing, on the basis of analysis to the current situation of the district government purchased basic medical and public health service, it uses the model to estimate the required cost to purchase the health service in the community endowment by the government and compares it with the actual expenditure. It analyzes in depth the result and experience of the government purchasing health service in community endowment in a district of Beijing which transformed the government function effectively and improved the government fund using efficiency. The people's satisfaction is forefront in survey in Beijing for many years.It proposes the target, system design and the countermeasures suggestion of the government purchasing the health service in the urban community endowment in China. It proposes the development target of government purchasing health service in the urban community endowment in China during the thirteenth five-year plan in addition to its mid-term and long term plan in the period of the year2020to2050. It has worked out the system design for the government purchasing the health service and proposes to set up the requirement investigation mechanism, information opening system, bidding mechanism and exit mechanism. It improves and perfects the financial security system, the performance appraisal and evaluation mechanism and the supervision mechanism. It ensures via the system construction the government purchasing the health service in the community endowment to be open, fair, competitive and ordered. Based on the system construction, it proposes to complete the top-level design, to figure out the reform path, to integrate the laws and regulations and the system construction, to provide the support and security, to be prepared for the relevant work of the medical reform, to actively construct and complete the elderly health insurance system, to establish the unified information management platform for the purpose of elderly health service, to make full use of the social workers function and countermeasures and suggestions etc. It has the important reference significance for making the thirteenth five-year plan of our country and further improving the work of the government purchasing health service in the urban community endowment.