Research On The New Rural Cooperative Medical System Of Pooling Funds For Outpatient Services Reimbursement Model In Shaanxi Province

In 2008, the Minister of Health clearly said:"We should explore to combind serious patient co-ordinate model with the Pooling funds for outpatient services together, so as to expand the system reimbursement level, to ensure that most of the farmers can benefit. "Since then, around the combination of serious patient co-ordinate with the Pooling funds for outpatient services has been steady progressed. At the first half of 2008, Shaanxi Province has been carried out the pilot of Pooling funds for outpatient services model, in practice, gradually exploring the total prepaid system and the head fixed contract system, these two Pooling funds for outpatient services reimbursement models are different. It is an innovation and a contribution for the whole country.Firstly, the theoretical basis of patient co-ordination in this paper were discussed, respectively, from the view of equity of health and risk society theory, outpatient co-ordination model can promote the utilization of health equity for the urban and rural resident, and effective share the disease risk. Secondly, the concept of outpatient co-ordinated model related are defined and introduced the implementation of outpatient co-ordinate model of xun-yi town and zhen-an town practice. Again, through field research and analysis of data collected from Xun-yi and Zhen-an town's practice nearly two years, analysis these four aspects respectively from the use of pooling funds for the out-patient services, the cost of each out-patient clinic, the reimbursement of each out-patient clinic, and the overall level of system compensation, based on this, concluded the existence of problems and ultimately improve the Pooling funds for outpatient services model of Shaanxi Province. Finally, sum up the experience of its effectiveness achieved, and the need for further research that is worth promoting. In conclusion, through the pilot town practice analysis found that, Pooling funds for outpatient services reimbursement expand the benefit of systems scope for urban and rural people, improve the farmers to utilize the pooling funds for outpatient services, promote primary health care services development and realization of health care resources equitable distribution, for disease prevention, while reducing the pressure payment of pooling funds for serious patient services.