Study On The Situation Of Health Service Utilization And Analysis Its Influence Factors For Rural Residents Under The New Rural Cooperative Medical System

Objectives: The new rural cooperative medical system (NCMS) in Fujian Province began trial operation in 2004 to 2008 covers all the agricultural population of the counties (cities, districts), enter the full implementation and consolidation stage. The study as the background of the NCMS's condition in Fujian Province, using the fourth health services survey's opportunity in 2008, to learn about the situation of health service utilization and its influence factors for rural residents after the implementation of the NCMS in Fujian Province, the views and evaluations of the NCMS's major stakeholders. To provide suggestions and reference for sustainable development of NCMS and the promotion of farmer's behavior, improve their health.Methods: The study collects relative data by referring the literatures, quantitative research and qualitative research methods. Quantitative study uses a questionnaire survey method, the questionnaire is asked about family health is designed by the national health services survey, the main aim is to learn about the demographic characteristics and health service utilization and impact factors for rural residents. Qualitative study uses semi-structured,key interviews and focus group discussion methods, to understand the NCMS key stakeholders'views,evaluations and recommendations on the NCMS. Finally, of the using the behavior theory to discussion and analysis and put forward countermeasures and suggestions.Conclusion:1 The NCMS is well-functioning in Fujian Province, builds a broad mass base, changes the rural residents had no medical insurance available, increases the level of protection of health of farmers. But the NCMS in the system design and enhanced monitoring and cost control still need to be further improved, then can better play a role. 2 The implementation of the NCMS promote the timely medical treatment for farmers, the health services utilization of farmers has increased significantly, the situation of unused health services has reduced, especially the use of hospital services grew faster. But the NCMS makes little impact on farmers in the out-patient health service utilization in Fujian Province.3 The health service utilization of rural residents by its internal factors (including gender, age, educational level, occupation etc) and the external environment (the NCMS and primary medical institutions) effects. In NCMS, rural residents are the most concerned about the hospital reimbursement ratio and whether can out-patient reimbursement. And, in the treatment choice of medical institutions, the farmers prefer to choose the primary medical institutions for treatment.4 By guiding rural residents understanding the disease correctly, improve self-care awareness, prevention and treatment of disease actively. And, by improving the external environment to facilitate the farmers seeking behavior, including raising the level of the NCMS funding, to accelerate general out-patient co-ordination, according to the farmers of different income compensation to formulate a scientific program, to improve the supervision and management of NCMS, and to improve the income level of farmers and primary health care service capabilities.