Analysis Of Equity On Health Care Utilization Of New Rural Cooperative Medical System

Objective To investigate the equity of health care services utilization among peasants in Xuanwei City which is the pilot county of the new rural cooperative medical system(abbr.NCMS)in Yunnan Province,in order to explore the way of improvement of equity on health care services utilization.Methods The study dourse included two aspects,the NCMS date were collected from 2 sample counties by filling out annual report forms and questionnaires.They included the documents of implementary schemes,the proportion of participants of NCMS financing funds,the derated fee of out-patients, the reduction of hospitalization charges,etc.Meanwhile,participants of NCMS who selected through review investigation in 2 sample counties,were interviewed for their comments and attitude toward NCMS by using a questionnaire.Xuanwei City(Laibin town,Jingwai town,1221 peasant households,4540 people)and Mengzi County (Chaoba town,Zhicun town,972 peasant households,4290 people),to analysis the different towns and families per capital income farmer health service use,and to analysis the health service use fairness.Results(1)The Xuanwei City two week prevalence rate is 8.0%,Mengzi County is 11.5%;Xuanwei City two week to see a doctor rate is 11.7%,Mengzi County is 18.2%;Xuanwei City two week not to see a doctor rate is 22.0%,Mengzi County is 13.4%;Xuanwei City hospitalized rate is 5.8%,Mengzi County is 8.7%; Xuanwei City has not been in hospital rate 8.4%,Mengzi County is 9.7%;the difference has statistics significance.Two place CI compares,Mengzi County's fairness surpasses Xuanwei City.(2)The Xuanwei City two villages and townsfarmers' medical expense,the year average per person medicine expense,the per person outpatient service expense,per person hospitalized expense and per person hospitalized compensation,the Laibin town obviously is higher than Jingwai county(t≥2.390,P≤0.024).Looking from the year average per person medical expense,between the different income farmer the difference has statistics significance,the financial circumstance is better,the year average per person medical service is higher,but accounts for the the proportion from per capital income to be actually lower(F=15.704,P＜0.001).Between the Mengzi County each investigation target the difference has non-statistics significance,fairness is good.(3)Used Non-Conditional Logistic Regression analysis past one year whether to be hospitalized,financial circumstance,past two weeks whether to be sick with past one year whether to contract chronic illness to affect the peasant household to be hospitalized.Past one year in hospital expense's Multiple Stepwise Regression analysis indicated that in hospital number of days and the place are important to hospital' expense.Conclusion Hygienic service's fairness should cause the matter of concern early,this when the NCMS gathered the experiment site started already had appearance.This article has discussed two experiment site counties' some reasons about the countryside resident health service use unfair,like the difference between the villages hospitals,NCMS implementation plan,economic development condition,geographical position as well as medical expense growth had certain influence,and discussed the way to enhance hygienic service use fairness,has served the research purpose in the certain extent.