The Research On The Benefiting Level From The Participating Farmers Who Have Joined The New Type Rural Cooperative Medical Scheme

With the development of the new type RCMS( rural cooperative medical scheme) and the consummator of information management system, Every trial counties have collected a plenty of detailed data of the participating farmers'reimbursement. This study is to investigate the data of the participating farmer' reimbursement from the trial counties'NCMS(The new type rural cooperative medical scheme) information system management soft and other data. Analyzing the structure and change of participating farmers benefiting condition and their expense including outpatient service expense, inpatient service expense and reimbursement expense. Our objective is to strengthen the reasonable and scientific reimbursement measures and broaden the beneficial area and improve the beneficial rate. This study has further consummated the new type RCMS system and offered some policy proposal reinforcing the rural health management and meet the service demand of rural health goodly.The objective of this study is the reimbursed population from the participating farmers in Wudi county Binzhou city. All the dada are from the background survey and soft dada used by the Wudi county' NCMS administration agency.The main contents include the following information: (1)to investigate the change of hygiene service utilization, including the charge of in-hospital the choice in the sort of fixed medical organization; (2) to analyse the charge in-hospital and the payment of reimbursement expenditure according to the different population, different level of medical organization, different expense in-hospital, different groups in age, different diseases, different reimbursement method and gender; (3)to study the use of outpatient service, such as charge, reimbursement method, etc; (4)to estimate the 2006 and 2007'reimbursement methods rationality.On the basis of descriptive analysis of the data from soft data, we analyses statistically those data referring to other statistical data.Results: 1.NCMS plays an important role in solving rural people's basic health care problem. The reimbursed inpatient service expenditure is 697 yuan per capita, and the reimbursed outpatient service expenditure is 21 yuan per capita. The total expenditure accounts for more than 42% of the very individual's life consumed expense in half year. The total inpatient expenditure in 2006 per person-time is 3172 yuan and reduced 1690 yuan, lower than that in 2005. 2. Farmers gained better and better clinic service. The outpatient expense per capita in 2006 is 67.1 yuan, which is 28.8 yuan, little higher than that in 2005. 3. The rural patients in-hospital are willing to choose the county's medical organization and even lower level than that to cure. The resident's hospitalisation rate among rural population is 37.8% in primary hospitals, 45.7% in secondary hospitals, 16.5% in tertiary hospitals on average in 2006. 4. There is a great difference among the inpatients' person-time in different inpatient expense standard and different medical organization. When the hospitalization expenditure is below 6000 yuan, the hospitalisation person-time in primary and secondary medical organization accounts for 77.7% among the total person-time of hospitalization, however the hospitalisation expense amounts for 53% of the total expense. 5. There are some unreasonable aspect in the NCMS' management method, (1)narrow benefiting scope, only 15.16%; (2)limiting reimbursing capability, inpatient reimbursing rate is 21.98% on average, outpatient reimbursing rate is only 15.16%; (3) lower outpatient fund level, it accounts for 21% of total spending; (4) overabundance surplus fund. The surplus fund level of annual financing fund, fund planning as a whole, family amount fund are 48.31%,40.06% and 78.88% respectively; 6. There are some unperfect problem in reimbursement method. Though there are an higher biggish improvement in inpatient reimbursement standard than that in 2006, it should be lower for the reimbursement standard of inpatient in 2007, which is maybe surplus.Conclusion and suggestion: 1.To further strengthen and consummate the type RCMS; 2. To increase financing amount step by step, individual charge should increase to 20 yuan per capita on the base of current 10 yuan to participants; 3. to establish reimbursement method scientifically and condensate family account little by little from 9 yuan to 5/3 yuan. Putting added fund to outpatients accounts, we gradually realize the new reimbursement method which is inpatients accounts plus outpatients accounts; 4. to set up reimbursement method scientifically, we should improve inpatient reimbursement scope. The most reimbursement in outpatient the farmers can get should be increased to 40-50 yuan; 5.To raise reimbursement standard and expand reimbursement scale and enlarge the benefiting scope; 6. to consummate fanners medical salvation system and ease poverty caused by diseases; 7. to strengthen the supervision and management of the fixed medical organizations and consummate the category of treating behavior; 8. to set up basic leechdom category and reduce the price of medicine and improve the using efficiency of the fund; 9. to further strengthen the construction of the rural hygiene serving ability; 10. to strengthen exploitation of information resource and exert the accelerating role of NCMS for the hygiene career.