The Operation Of The Resent Key Implementation Scheme Medical And Health System Reform (2009-2010) In Gansu

Objective It is aimed to understand the operating conditions of the basic medical and health service system reform in Gansu after the implementation of new medical reform and summarize the operation effect of The Resent Key Implementation Scheme Medical and Health System Reform (2009-2010) in Gansu by investigating the present situation of the basic medical and health service system reform in Gansu,. It is found that the basic medical and health institutions have some problems in the aspects of the building of the basic medical insurance system, the implementation of the national essential drug system, the improvement of the community-level medical and health service system, the promotion of the gradual equalization of basic public health services and the reform of public hospitals. The factors of existing problems are analysed. We analyse the completion of the key reform tasks, evaluate the effect and the problems and popularize good experience. In view of new situations and new problems the strategy on how to carry out The Implementation Plan successfully is put forward according to the change of policy environment. It is studied that how the medical reform work is arranged in2011and how the implementation scheme of the refonnis made up during the period of "The12th Five-Year Plan".Methods According to the time of the first batch of the implementation of the national essential drug system it is divided into two categories:one is pilot county (district, city), the other is non pilot county (district, city).15randomly selected samples respectively from the pilot and non-pilot county (area, city) are studied as the object. The main investigation includes the basic medical security system, the national essential drug system, the basic medical and health service system, gradual equalization of basic public health services and the public hospital reform. It involves the hospitalization expense, the basic drug system construction, the basic drug sales, basic public health services, major public health service project and etc.Based on the theories of health statistics, health economics, health policy and social medicine and other disciplines, the construction and the development of the medicine health system reform in Gansu are discussed and analyzed. By comprehensively elaborating the present medical reform situation in the sample30counties, we select the relevant evaluation index to evaluate the effect of related work. At the same time, by the method of comparison the related situations in different years are compared with the situations in pilot counties and non-pilot counties.Results (1) The work of enlarging the basic health care coverage in Gansu has gained remarkable success. The numbers of participants in the three basic medical insurance principles are respectively2,902,200,2,985,700and19,103,200. The insurance rate respectively reaches99.05%,96.62%and95.92%. Both the number of participants and the participation rate have exceeded the target proposed in The Implementation Plan.(2) In accordance with the basic drug control regulations Gansu all over the province brings all the township hospitals organized by the government, the centers of community health service and the village health rooms bearing the basic public health service into the range of the implementation of national essential drug system and realize zero error rate sales work. The coverage rate of the national essential drug system has reached100%.(3) The urban and rural medical and health service system has been initially built in Gansu, improving the accessibility and the availability of health services. At the same time, the number of the urban and rural medical and health service institutes has increased obviously with the improvement of the service ability. From2008to2010, the compliance rate of county level hospitals in Gansu increases from79.09%to97.67%, and the growth rate is beyond18%. From2008to2010, the staff and health technical personnel quantity in basic medical institutions of Gansu province increases year by year. The proportion of health technical personnel has remained relatively stable in2008and in2009. The proportion of health technical personnel in Gansu in2010has increased by23.6%compared with that in2009.(4) Gansu has achieved satisfactory results in the work of promoting the equalization of basic public health services. The three important evaluation indice, namely the establishing rate of residents’ health archives, the management rate of the patients with hypertension and the management rate of the diabetic patient, have gained relatively remarkable success. By the end of2010, the number of health files established for residents in Gansu have reached13,929,605, occupying53%of the resident population in Gansu. Moreover, the health files of3,014,535residents are managed by computer, and the computer management rate of health archives all over the province has reached22%. Since the program of the equalization of basic public health services was implemented, the province’s total number of hypertension patients with registration management has been more than660,000, and the health management rate of hypertension has reached67%.Conclusion The work of enlarging the basic health care coverage in Gansu has gained remarkable success. the centers of community health service and the village health rooms bearing the basic public health service into the range of the implementation of national essential drug system and realize zero error rate sales work. The number of the urban and rural medical and health service institutes has increased obviously with the improvement of the service ability. Gansu has achieved satisfactory results in the work of promoting the equalization of basic public health services.