Study On Financial Access To Health Services

Objective:To analyze the financial access to health services of different income groups and the difference among them, and to study the effects of health care system, health financing and compensation costs on financial access. To study and improve the strategy of China medical service financial access, to provide the theory and information basis for medical deciders and researchers, and then to adjust and refund medical policy; to realize the harmony among equity, efficiency and quality; to increase the equity and accessibility of health services for the poor and to achieve universal access to basic health services for the majority of the people's health services.Methods:Referring to the Fourth National Health Service Survey Report and the Study of Total Health Expenditure in 2009, China Health Statistics Yearbook in 2009, Liaoning province Household Survey data in 2006 and other related data, it explains the concept of financial access to health services and its factors, significance and policy focus. Based on the theory of equity and using the indicators system evaluation of the conceptual framework of financial access to health services, it analyzes the status and differences of financial access of different income groups and the groups of different medical insurance coverage available, and evaluates the process of the improvement of financial access in China from three major aspects, including "capacity to pay health services of residents", "health insurance coverage and compensation situation", and "use of medical services of people and influence factors"; it also comparatively analyzes differences of financial access to health services of different income countries, summarizes the should learned national cases of improving the financial access and draws strategies which can be to improve financial access to health services in China.Results:Along with the continuous improvement of the basic health insurance system and the increase rate of low-income people to participate in social insurance, the financial burden of residents insured for the family has been significantly reduced, and the financial access to health services has been improved. However, the financial access of the residents is still not optimistic, and the financial burden of out of pocket expenses is still heavy. According to the Fourth National Health Services Survey, the ratio of hospital fees covered by urban workers, urban residents and the new rural cooperative Medical insurance is 36.8%,50.7% and 73.4% respectively in 2008; the "economic hardship" remains the main and important reason to block the using of medical services for residents. Meanwhile, not only urban and rural residents have apparent gap of financial access, but also the different income groups and groups of different medical insurance coverage have the same problem.. Rural residents who participate in the new rural cooperative based health system have less financial access than urban workers and residents; medical and health resources allocation between different income groups is unfair and benefits the high-income class. The poor have less possibility to get benefits and have less financial access to health services.Conclusion:Among different economic sectors, there are differences in the current design of the medical security system in financial access; the existing health care system can not fundamentally solve financial access issues, and it can not be enough to really improve the financial access to health services for disadvantaged groups. Therefore, it is necessary to design a new system and improve policies, which can meet the demand for health services in poor communities, emphasis on increasing equity; to adopt appropriate strategies to improve health services financing and financial access for poor people, to achieve harmony among equity, efficiency and quality, so as to the masses can enjoy a fair and accessible basic health services.