Analysis On The Variational Trend Of Utilization Of Inpatient Health Services Of Rural Residents In China

Objective: Making use of the datum of national health services survey inl993, 1998 and 2003 in China, and to analysis on the variational trend of inpatient services utilization of rural residents, and to provide basis for providing basic health services for rural residents, and using limited health resources reasonably, and ensuring basic health services demand, and drawing up the development strategy and health manpower programming.Methods: According to the datum of national health services survey in 1993, 1998 and 2003, and to carry on the time-serial descriptive analysis on the hospitalization rate, the average days of hospitalization, the situation that person should be in hospital but wasn't in hospital, the medical fee of hospitalization, the disease classification of inpatient, the distribution of health organization that selected in hospital, and the main influential factors of hospitalization (such as gender, age, the level of education, marital status, occupation, medical care and the level of income etc.) in rural area firstly, and then to make use of the grey model GM(1,1) to carry on the Grey-prediction for the main index of inpatient health services utilization, such as the hospitalization rate, the average days of hospitalization, the rate of non-hospitalization, the average fee of hospitalization etc, and to check up the suitable degree. According to the forecasting results and the international and national situation of relative research, to put forward suggestions to the development thinking and strategies of new rural cooperative medical system, and health manpower programming, and to raise the health level of rural residents, and to use health resources in rural area in effect.Results: The utilization of inpatient health services of rural residents in China showed the up-trend totally. From 1993 to 1998, the variety range of the hospitalization rate was not big, A, D regions' showed increase slightly, and B region reduced slightly, and C region held even. According to the results of the Grey-prediction, the situation of hospitalization rate of all kinds of rural areas was similar in the period of 1993 to 1998 and 1998 to 2003. The utilization of inpatient health services of rural residents showed the up-trend totally, and the variety range of the hospitalization rate was similar, B, C and D regions were good to match the trend, A region's inpatient services utilization will reduce slightly in 2008's national health services survey by the forecasting results.From 1993 to 2003, the average days of hospitalization in all kinds of rural areas showed the down-trend, and reduced 2 days per 5 years. According to the forecasting results, it will still show the down-trend in 2008's national health services survey. That is, the average days of hospitalization of rural residents will reduce continuously, and the descending range exists no difference in the statistics in contrast to the 2003's data.From 1993 to 2008, the non-hospitalization rate of rural residents showed the down-trend all along. In the period of 1993 to 1998, the descending range was slightly big. In the period of 1998 to 2003 and 2003 to 2008, the variety range held even.The direct fee of hospitalization of rural residents increased sharply, and it was up to 1455 yuan in 2003, that was 2.7 times in contrast to the result of 1993. According to the results of Grey-prediction, the direct fee of hospitalization of rural residents will be up to 2475 yuan in 2008's national health services survey.By the prediction, in the rural areas, the hospitalization rate will be 3.7 percent, the average days of hospitalization will be 8.2 days, the non-hospitalization rate will be 26.51 percent, and the average fee of hospitalization will be 2475.3 yuan in 2008. The main influential factors of inpatient services utilization in rural area were that, economics increasing slowly, the low level of medical care, and the medical fee increasing sharply etc.Conclusions: The hospitalization rate and the fee of hospitalization increasing synchronously, while the average days of hospitalization and the non-hospitalization rate will descend. The government should adopt some homologous plans and measures, so as to increase the utilization rate of inpatient health services of rural residents, such as speeding up the development of rural economics and reducing the burden of farmer actually, nailing down the governmental function in the health realm, outstanding the primary prevention and strengthening health education and health promotion and improving the health status in rural areas, building up the medical care system and raising the utilization rate of inpatient health services of the weak group in rural areas, pushing forward the new rural cooperative medical system and the other models about medical insurance actively, enhancing the basic construction of rural health services and the education of health manpower, incarnating really to take the village as the keystone of health services, and relaxing the reasonless situation about the distribution of health organization that selected in hospital etc.