An Evaluation On Operative Effect Of New Rural Cooperative Medical System In Different Stages Of Henan Province

ObjectiveIn this study, the implementation of New Rural Cooperative Medical System of Henan Province was divided into pilot phase, expansion phase and the full-implementation phase. We summed up achievements and problems of New Rural Cooperative Medical System in different stages of development, and put forward coping strategies towards the existing problems, so as to provide basis for decision making.MethodsA study by cluster sampling was conducted.18 counties (cities), the first implementation of the New Rural Cooperative Medical System of Henan Province, were set as sample of the county. Based on 18 counties'(cities') operation and data of New Rural Cooperative Medical System from 2003 to 2010, we took literature research, quantitative research, comparative analysis and the method of linear correlation to compare and analyze participating case, funds use, benefiting situation of farmers as well as the flow and compensation costs of the different medical institutions.Results1. Participation rate of New Rural Cooperative Medical System increased year by year, which from 73.70%in 2003-2004 increased to 96.85%in 2010. And the actual hospital compensation percentage rose year by year, which the rate of 2003 and 2004 was 26.44%, in 2007 it increased to 30.44%and further more it increased to 39.92%in 2010.2. Fund of New Rural Cooperative Medical System mainly based on hospital compensation expenses. And hospital compensation expenses ratio of total expenditure was rising year by year, which in 2008 it reached to 83.56%. Overall fund utilization rate of New Rural Cooperative Medical System of these 18 counties increased year by year, which in 2005,2008 and 2009 the ratio were over 100%and overrun seriously.3. Overall benefit rate fluctuated greatly in different years. In 2010 it was the highest which reached to 193.15%. In 2007 it was the lowest which reached to 66.16%. Hospitalization benefit rate was increasing year by year, which in 2010 it reached to 6.85%.4. View from flow of the cost of medical institutions at all levels and cost structure analysis of compensation, hospitalization expenditure per patient outside the county medical institutions was the highest which reached to over 5000 Yuan, and actual hospital compensation outside the county medical institutions was the lowest. While in rural medical institutions, hospitalization expenditure per patient was the lowest which were below 1500 Yuan, and its actual hospital compensation was the highest which in 2010 it reached to 59.11%.5. After analyzing the affecting factors of 18 counties'(cities') operation effect of New Rural Cooperative Medical System, the result showed that hospitalization compensation per patient and actual hospital compensation respectively were positively correlated with per-capita funding levels (P<0.05). Hospitalization compensation per patient was positively correlated with hospitalization expenditure per patient (P＜0.05). There was no correlation between pays hospitalization per patient and per-capita funding level (P> 0.05). And pays hospitalization per patient was positively correlated with hospitalization expenditure per patient (P＜0.05). There was no correlation between actual hospital compensation and hospitalization expenditure per patient(P> 0.05).ConclusionsDuring 8 years of carrying out New Rural Cooperative Medical System of Henan Province, participation people and its rate increased year by year, and the level of safeguard and security management of New Rural Cooperative Medical System improved continuously. In the early of pilot phase, participation rate was inferior, financing was difficult, fund amount was lesser and fund anti-risk ability was weak. In expansion phase, fund balance of the New Rural Cooperative Medical System which affected the benefit degree of the farmers was overmuch. In full-implementation phase, Due to the directory external use ratio of New Rural Cooperative Medical System increased unceasingly, participating farmers'medical expense increased, which aggravated the burden of patients, meanwhile the actual hospital compensation percentage was lesser and the overall fund pay rate was higher. Among them, the overall fund use in the year of 2008 and 2009 overrun seriously.