A Study On Out-patient Services For Rural Residents At Two Administrative Levels

Objective Through investigating the information of the investigated areas medical services in rural medical institutions and rural medical practitioners at the scene,to research the situation on the outpatient care service provide and utilization, to evaluate the trends of rural residents'out-patient services utilization and the outpatient fees, to explore the influence of outpatient service at two-level that caused by rural cooperative medical system and provides policy suggestions for the new rural cooperative medical system. Materials and methods Choosing the township which is implementat cooperative medical system in 2000-2003, and according to the population, economic level of the intervention group set three towns as control group, respectively, compared with their intervention and with blank.The survey includes the 1997~2006 out-patient prescriptions and registers in investigated four township areas. Investigated Agency information at the scene to collect and extract rural medical institution patients in out-patient registration information and treatment and fees of the outpatients at two-level. Results (1) In the out-patient constitute under 25 years male were more than women, 25 to 54-year-old female ratio more than male. The proportion of elders more than 55 years increased attendance, the patients under the age of 5, 25 ~ 34-year-old declined in the proportion. (2) respiratory diseases, digestive system diseases, skin and subcutaneous tissue diseases, circulatory diseases, Female reproductive and breast disease, injury and poisoning is located the top six in out-patient treatment of rural residents disease constitute. (3) The digestive system disease, the skin and subcutaneous tissue disease, female reproductive system and breast disease (including gynecological tumors) were impacted by cooperative medical system, but it did not play in the village level. (4) The antibiotics, hormones in the body with the use of outpatient visits had a higher proportion, respectively 28.10% and 5.60%. The number of Chinese traditional medicine prescriptions declined year-by-year, there was an increase in the application of Traditional Chinese patent medicines. (5) The ratio of use a combination of drugs rose, the kinds of combination of drugs in village were more than township hospitals, and the intervention group was higher too. (6) The antibiotics, hormones in the body were used much more in village clinics than township hospitals, intervention group higher than those in the control group. (7) The average cost of prescription increased by stage, and the costs of men are higher; the intervention group prescription costs are higher than the control group in every age group. Conclusion The view that institutions should strengthen primary health care information management and the building of rural doctors, emphasis on the health of special groups to carry out monitoring, strengthening the village health medication management, to promote the rational and safe drug and control prescription costs rise unreasonable.