| BackgroundsIn 2007, the NCMS turned to the overall promotion stage from the demonstration projects, and it has already covered 80% counties in China. There was a great deal of surplus of the foundation, due to the restriction of the sanitary control level and the knowledge lack of the local medical service and consumption during the first two years. People of some regions had tried to carry out the second reimbursement for the sake of the utilization of the foundation and the largest profit of the people. But there are various means and many problems worthy of concern in these areas. At present, people have different viewpoints and recognitions regarding these issues.ObjectivesThe research will make study and evaluation concerning present condition, funding source, means and procedure, problems and performance effects of second reimbursement of the NCMS. And it will analyze the necessity and the possibility of the second reimbursement of the NCMS based on the theories and practices.Through research it will introduce the principal, suitable condition, funding source, operation style and regulation in order to regulate the means of second reimbursement. And the research will furnish theoretical and practical foundation for the high usage of medical fund and the largest profit of people and the development of the cooperative medical institution.Methods Information and materials of the research originated from Information Handbook of the NCMS from 2003 to 2006 of rural health supervision department (RHSD) of Ministry of Public Health (MPH). After designing schedule table and visiting outline, we follow typical sampling principal and undertake field investigation and visit in 10 counties with typical cooperation health care from 5 provinces on the basis of fund resource and compensation means. We emphatically investigate the operation circumstance of the NCMS especially the second reimbursement in the sample counties, and we also carry out letter investigation to the 6 provinces without second reimbursement. We make quantitive analysis and model analysis to typical targets and make qualitative analysis to visiting materials and letter information.Main resultsThe investigation results demonstrates the second reimbursement of the NCMS had necessarily raised the compensation rate and the foundation usage and people' participate. The second reimbursement contributes much to raise the participants' compensation level and lessen the participants' medical expenses burden, and it also contributes to put compensation scheme into practice and use the funding reasonably and prevent it from operation risk.Though the second reimbursement of the NCMS has some problems such as indeterminateness and polytropy of operation, various compensation modes, increasing work load and administration cost .It needs to be regulated and perfected in order to improve the NCMS. Conclusions and suggestionsThe investigation founding demonstrates the second reimbursement of the NCMS necessarily plays an important role in raising the compensation level of the participants and increasing the foundation utilization rate. People of the regions related should understand the definition and applicable condition and principal of the second reimbursement of the NCMS, and establish the scheme of second reimbursement and the announcements reasonably. Then they further regulate the mode and the procedure of the second reimbursement with regulations and announcements established. Supervision is necessary for reasonable operation of the second reimbursement of the NCMS. Simultaneously they regard the second reimbursement as temporary regulation means before the reasonable compensation scheme, and they should strive for perfect once compensation on the basis of an improved compensation scheme. All above are conducive to participants' largest profit and foundation's utilization and the fine development of the NCMS. |
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