Situation And Evaluation On Medical Financial Assistant In Rural Area In Henan Province

ObjectiveTo put into effect ten facts which was undertaked by Provincial Committee of the Communist Party of China and Provincial Government and the quest of Ministry of Civil Affairs,Ministry of Health and Ministry of Finance,HeNan Provincial Bureau of Health,Bureau of Civil Affairs and Bureau of Finance unitedly dispatched to start up roundly Rural Medical Assistance of HeNan province in the end of 2005.Since the work began ,it has been runned all right,but it still has a little difference with ideal state.There are some unreasonable phenorena such as "poor helps rich",object(target population)who should not gain assistance,nonstandard operation,greater proportion of deposited salvage fund and so on.It has been a very important urgent question faced to all level leaders and deportments to resolve the difficulty of getting medical service and the expensive medical care which weak population often meets.To know the experience of Rural Medical Assistance and questions in existence, to build the scientific ,normative ,perfect and effective institutions of Rural Medical Assistance , HeNan Provincial Bureau of Health leaded and organized the special investigation of Rural Medical Assistance in order to offer consultation and reference to leading institutions and administrations.Materials and methods1. subjects investigated:Select families joining HeNan Rural Medical Assistance and the New Rural Loopercotive Medical Scheme(NCMS) from two experimental countys and poor and no-poor families from control county as subjects investigated.2.variables investigated: It includes indexes about fund source ,scale ,constitution,management and operation ;health service indicators .3. research methods:Using suitable indexes to evaluate the development and effection of Rural Medical Assistance.(1)monitoring :using descriptive procedure to evaluate the progress of Rural Medical Assistance;(2)effective evaluation:using benefit,disease economical burden and its influencing factors,economic risk coefficient K of medical assistance resisting diseases to evaluate the validity of poverty medical assistance.4. statistical methods.Data entry ,auditing and analysis with the softwares ofEpidata and SPSS 13.0,and the main statistical analysis methods have U test, x~2 test ,rank sum test ,multi-line regression and logistic regression analysis.Result1. In the field inquiration crowd, the poor family compared to the common :the proportion of the old ,the illieracy and the functional literacy ,the disabilited,two-week morbidity rate ,chorinic disease case rate was higher, however ,their adimission and hospitalization rate was lower.2 .NCMS and Rural Medical Assistance alleviated partially economic burden and improved aimed farmers to use health services.In WUZHI and GONGYI (experimental countys) which have developed NCMS and Rural Medical Assistance ,RUYANG (control county) which developed just now Rural Medical Assistance , fraction of coverage Rural Medical Assistance has reached 2.82% and exceeded 2% which is original aim.In 2005,13.02 ten thousand person-times gained out-patient clinic 28.02 ten thousand yuan compensation and 976 person-times gained hospitalizational 42.3 ten thousand yuan compensation and 328 person-times gained 26.2 ten thousand of second salvation.3. The monitoring evaluation of the development of medical assistance is : (l)the range of raise funds is too narrow ,the public welfare fund of lottery ,social contributions and interest returns which should be raises by governamental rules all are zero;(2)the process of confirming the objects of medical assistance is not transparent:61.2% of rural population don't or rare know the system of the medical assistance ;(3)the drumbeating work need be strengthened :52.6% of rural poor families don't understand the card of medical assistance,and 80.9% of poor families don't know to lodge a complain while occurring medical dipute.4. Effective evaluation of medical assistance:(1)the utility of health service:the level of health service of poor families is lower than that of averge families and the difference is statistical significant;(2)the expenditure of health service :there is not statistical significance between poor pamilies and averge families;(3)the factors that effect the utility and expenditure of health service are poor or not and whether was medical assitance etc (4)the media of economic risk coefficient K of medical assistance resisting diseases is 0.09.Conclusion1 .The function of coverage is rather high;the utility rate of medical service increased in the objects of medical assistance.On the other hand ,the definition of object of medical assistance is not just or nermative;the source of the fund of medical assistance is single;the service ability of rural medical establishments is low-lying;the level of supervisor agencys need be hightenned,and so on.2.The effection of Rural Medical Assistance : Rural Medical Assistance advanced the utility of health service of the objects,and partaked the disease economic risk of the objects.3.Policy advice:widening actively the channels of raising funds;establishing specializedly the package of health service for the objects;assuring the healthy and continuable development of Rural Medical Assistance.4.The project used appropriate indictors to evaluate the process and effection of Rural Medical Assistance,and provide the reference for the progress and perfection of the institution of Rural Medical Assistance.