The Influential Factors And Promotion Paths Of The Access To Basic Medical Services

Access to basic medical services is a fundamental right of citizens of a modern society.China has already paved her way to solve the problem that seeing a doctor is too expensive and the resources are not distributed equally,and try her best to achieve the goal that everyone can enjoy the right in 2020.Scholars have discussed a lot about the access to basic medical service,its Influential factors and their promotion paths.The existing researches,however,show that the results based on data from various countries differ a lot while the data and cases of China is scarce.Therefore,it is difficult to transplant the results of foreign researches to China directly,which make it important to classify the definition,and the Influential factors of the access to basic medical care and then find their promotion paths and propose policy recommendations.Hence,in order to discuss the interaction among environmental factors,structure factors and actors of health delivery process and its impact on the access to basic medical services,this research proposes an analytical framework with the dynamics of supply-demand configurations after conceptualizing the definition in two directions namely supply side and demand side respectively.On the supply side,the definition is made up of the access to space,equipment,human resources and medicine,which on the demand side,is the access to payment.Zhejiang Province as a relatively developed area of China is a model of other developing provinces,which make Zhejiang show a potential future of other provinces.Hence,this research adopts study objects in Zhejiang.On the one hand,a top hospital in Ningbo is adopted and all in-patients of the hospital in 2014 are studied to classify the impact factors that affect the citizens' use of health care services on the demand side;on the other hand,the basic medical services systems of Ninghai county,Songyang County and Haiyan County are adopted as cases to be studied to classify the Influential factors of the access to basic medical services on the supply side.The results show that on the demand side,the payment level of health insurance would affect the citizens5 use of health care services positively,which,however,is not a linear relationship.The more generous the health insurance is,the more severe supply-induced-demand is,which will at least offset part of the positive influence on the access to basic medical services of the increasing capacity to pay.On the supply side,the structure factors like economic development,government investment as well as geographical factors will affect the access to basic medical services while the actor factors like the health sectors,sickness funds and the relationship among them are also significantly related to the access to basic medical services.Therefore,to promote the access to basic medical services,it is important to make an effort on both supply side and demand side.On the demand side,to nurture and transfer functions of government to actors like sickness funds,achieve managed competition,strengthen management capacity of sickness funds are important paths to promote the access to basic medical services.On the supply side,except for developing the economy and increasing the investment,to improve the governance structure of basic medical services,encourage the supply of the private hospitals are important paths.