Reasons And Countermeasures Of Medical Care Utilization Difference By Shanghai Residents Under New Duality Structure

Study Background and SignificanceWith the urbanization process, a large number of rural surplus labor force constantlyflow into the cities. Because of social status difference between rural labor force and urbanresidents and the relatively high mobility of rural labor force, the difference of health careutilization between these two parties is becoming more and more significant. The dramaticincrease of foreign population in Shanghai will definitely intensify Shanghai New DualStructure. If the basic health care service for those foreign populations can not beguaranteed, the social structure instability and social relationship disharmony may occurand the social order is also in potential trouble. Therefore, taking in to considerationbuilding a harmonious society or protecting residents’ basic rights for health, we shouldpay attention to the health status of foreign residents in the city and improve theirutilization of medical service. Only in this case, governmental welfare policies can beeffectively implemented and social health care can be healthily advanced and developed.Study PurposeThrough the study, field research and analysis on the status quo and differences ofresidents’ medical service utilization under Shanghai new dual structure and by exploringthe potential factors and policies which influence residents’ medical service utilization,suggestions are put forward to relive the differences.Study Content1. Connotations of new dual structure and basic theoretical research on medicalservice utilization. Through inspections of books and documents, this paper defined thecontent of new dual structure, and the causes, formation process and harms of Shanghainew dual structure. It also demonstrates the necessity to ensure the fair utilization ofmedical service under new dual structure based on the theory of Public Goods and thetheory of fairness.2. Research on the status quo of Shanghai residents’ medical service utilization underthe new dual structure. By analyzing the supply, demand and actual utilization of residents’medical service, this paper has explored the status quo of Shanghai residents’ medical service utilization under the new dual structure and the reasons that caused the differences.Finally, taking into account the special nature of these differences, the early-warningsystem has been built.3. Empirical analysis on the medical service utilization differences under Shanghainew dual structure. Songjiang district is selected for empirical analysis. Through fieldresearch, the status quo and differences of health care utilization of foreign and localresidents in Songjiang district. Finally, this paper conducts empirical analysis on theearly-warning model.4. Analysis of reasons which cause the differences in Shanghai new dual structure.Factors which may influence the health care utilization of new dual structure have beenanalyzed. And the state and Shanghai policies have also been taken into consideration.Finally this paper digs out the real reasons for differences between groups.5. Countermeasures and proposals to relieve the medical service utilizationdifferences of the new dual structure. First, residents’ needs for health care in the surveyedregion and utilization index have been estimated. Secondly, suggestions andcountermeasures have been put forward to relieve the differences.Study MethodsFirst, this study conducts basic analysis on the current situation through reading books,documents and statistics. Secondly, by utilizing gray relation and gray clustering analysismethods, early-warning model for indicating the differences of new dual structure’smedical service utilization basing on Grey Modeling Software and R Software. Thirdly, inthe field research, data of the survey have been analyzed by using EpiData software.Finally, factors that may influence residents’ medical service utilization have beenanalyzed by using Logistic Regression Multiple Regression Analysis and SASS software.Study Result1. Research on the status quo of residents’medical service utilization of Shanghai newdual structure shows that, first of all, although the health care resource is becoming richer,resource allocation is not rational enough and it should be improved. Secondly, the medicalservice demand and utilization level of the foreign population are much lower than those oflocal residents. The phenomenon of Three Lows and Two Highs is quite obvious and thedifference is remarkable.2. Field research on the medical service utilization of the new dual structure showsthat, first of all, big differences exit between the two parties of the new dual structure in age, education level and job. Secondly, economic level, health insurance coverage, medicalcare availability, medical service demand and treatment utilization of the foreignpopulation are much lower than the local native population. The utilization level ofinpatient service has increased. Thirdly, the patients prefer to buy drugs in the pharmacy bythemselves, and community health service organizations have not become their priority yet.Lastly, both the two parties of the new dual structure are not quite satisfied with medicalservice.3. Reason analysis of the difference shows that, first of all, from the perspective ofmultivariate analysis, social status and economic level are determinative factors that affectthe new dual structure’s medical service utilization. Age and self-rated health status aremajor factors that affect the residents’ utilization of outpatient services. The householdsystem and self-rated health status are major factors affecting residents’ utilization ofinpatient services. The level of illness severity and inpatient service make great impact onthe medical service expense. Secondly, from the perspective of policy analysis, the nationhas no specific policy toward foreign population in the city. And foreign policy itself isanomie. There is no unified name for foreign population. What’s more, relevant policies invarious departments are in serious disorder. Health authorities and medical institutions arealso lack of appropriate policy and financial support.Summary and Countermeasures1. Residents’ medical service needs in new dual structure and medical serviceutilization index have been estimated.2. Ideas to narrow the differences in medical service utilization under the new dualstructure have been established based on4perspectives: setting the goal, following the fiveprinciples, promoting ideological reform, stressing the basic institutional arrangements.3. By emphasis on defining government’s responsibility, reforming and improvingcurrent economic policies in health care industry, improving health care system, focus onrational resource allocations and carrying out health care education, suggestions andcountermeasures to narrow the differences in medical service utilization under the new dualstructure have been put forward.