The Investigation And Policy Research Of The New Rural Cooperative Medical Service In Dengta City

IntroductionThe cooperative medical treatment system had once played a vital role indeveloping rural medical safeguard form and eliminating medical pressure for thefarmer in quite a long time as a kind of Medical safeguard systems. Establishing andconsummating new rural cooperative medical service system may not only safeguardthe farmer to have the basic medical health care service and alleviate the farmer tobecome poverty and return poverty because of sickness, but also may fully use thesanitation resources and promote the countryside social economy development.This article mainly discuss the necessity and the feasibility of establishing andconsummating the new rural cooperative medical service according to analysis theactual situation and problems existing in the new rural cooperative medical service.Propose the policy suggestion to consummate the new rural cooperation medicalservice. Supply scientific evidence for constituting sanitary policy and health program,improving the sanitary level of Deng Ta city, satisfying the basic health service demandand advancing the health situation of rural residents.Object and MethodWe used cluster sampling method to survey the health service demand andutilization of rural residents in three towns and nine villages in Deng Ta City and.Samples amount to 818 households, 2,304 people.Meanwhile we have carried on the review survey to the database materialsanalysis the data of 312,000 person who participated in new rural cooperativemedical service from 1 April, 2006 to 31 December,2006．The questionnaire is revised by the experts of sociological medicine, epidemiology and statistics. The investigators have been trained and quality control hadbeen paid attention to simultaneously. Full time personnel are responsible to the datainput and professional check.ResultsResults of survey on health service demand of rural residents showed thattwo-week prevalence rate of the investigated population is 9．1%, two-weekexamination rate is 8．0% and two-week no-examination rate is 5．9%.The medicalexpense of outpatient of rural residents is 327．1yuan per person, including the drugexpense 210．7yuan per person and it accounts for 64．4% of the total medical expenses.The medical expense of the hospitalization of rural residents is 8151．2yuan per person,including the drug expense 210．7 yuan per person and it accounts for 54．8% of the totalmedical expenses.62．5% rural residents choose to diagnose in the village clinic, 44．64% in-patientschoose to diagnose in the hospital above village level. The higher the rank of medicalorganization, the more the medical expense is.From the recent investigation of the new rural cooperative medical service, thefund of the new rural cooperative medical service in Deng Ta City is 12．48million ,including the fund 3．12 million of the farms themselves ,2．34 million from thefinance of Deng Ta city , 2．57 million from Liaoyang finance, 4．45 million fromLiaoning Province finance .It concludes family account fund 3．12million, venture fund468 thousands.There are 90,492 farmers who benefited from the new rural cooperative medicalservice, which accounts for 29% of the total farmers. It includes 54,723 family accountpeople and 29,876outpatiens, and adds up to 84,599 people, which accounts for 27% ofthe total farmers. The rest 2% benefited are inpatients. The total subsidy fund of thenew rural cooperative medical service is 6．4 million from 1 April, 2006 to 31December, 2006, which includes family account expends 1．82 million and the overallplan subsidy 4．58 million which includes outpatient service subsidy 280 thousands and inpatient service subsidy 4．3 million .The residual fund is 38．75%. The outpatientservice compensating rate is 17．81% and the inpatient compensating rate is 23．96%.The compensating expense of the new rural cooperatives medical service accounts for51．28% of the total fund. There are 5,893 people obtaining hospital subsidy, theinpatient expense for each farmer is 3033．97 yuan per time and each farmer can obtainhospitalized compensation 729．68 Yuan.DiscussionsThe prevalence rate and chronic illness prevalence rate of our survey are lowerthan that of the national countryside average level in 2003．Two-week no-examinationrate is higher than that of the national countryside average level in 2003．The higher theincome is, the lower the unhospitalized rate is. The proportion of medical examinationreceiving in the villages and towns is lower than that in the domestic related report;The medical expense of each outpatient and each inpatient is higher than that ofthe national countryside average level in 2003．The research discovered that themedical demand of the countryside inhabitants is very large and the main reason whythe medical service has not been used fully is the excessively higher medical and drugexpense. Obviously, the way to solve the basic medical service demand of ruralresidents is not to built new hospitals and increase the number of sickbeds, but is toreform the health system and the medical management mechanism of the presentmedical service and to control the speed of increasing medical expense and to share themedical burden of the farmer patients. The cooperative medical treatment system mayprovide the basic medical service for the farmer by using the lower medicine expense,reduce the burden of medical expenses for the farmer patients , reduce the probabilityof becoming poorer because of sickness in farmers, adjust the distribution of patientsand increase the business margin of the health organization in village. Therefore thecooperative medical treatment system is advantageous to the stabilizing and advancingthe countryside health organization. But there are still many problems worthy of furtherstudying according to actual situation in each place and the wish of the population in countryside.We discovered the several questions on the basis of the present situationinvestigation of the new rural cooperative medical service in Deng Ta City. First is thatthe rate of compensating and benefiting of the new rural corporative medical fund islower and the residual rate of the fund is higher. Second is that above 50% benefitedfarmers were hospitalized in province level health organization.The more the residual account fund is, the lower benefits farmers can receive. Thiswill affect the farmer's trust to the new rural cooperative medical service , furthermorereduce the rate of participation in cooperative medical treatment and affect thedevelopment of the new rural cooperative medical service.ConclusionsAccording to the analysis, we may conclude that the benefiting rate andcompensating rate in Deng Ta City is not high and the residual fund is too much .Inorder to change the present condition and promotes the sustainable development of thenew rural cooperative medical service in Deng Ta City , we provide followingsuggestions. First, we must strengthen the construction of health organization belowthe county level, in particular the constructing of the public health center in villages andtowns .Second, we should further adjust the plan of the new rural cooperative medicalservice according to the situation of 2006 . Third, we need to strengthen the supervisionto health organization. Fourth, we must propagandize the benefits of the new ruralcooperative medical service to farmers to improve the farmer's cognition to the newrural cooperative medical service.