The Impact Of The New Rural Cooperative Medical System On Farmers’ Medical Services Utilization

Improving the health of all residents is the ultimate goal of health policy. This not only depends on the level of investment in medical care resources, but also depends on the effective use of medical services. For rural residents that account for the majority of the population in our country, the effective use of medical services is directly related to their health, as well as affecting their human capital and quality of life. Since the reform and opening, due to lack of medical insurance in rural areas, the level of utilization of medical services for rural residents is much lower than their medical needs. Furthermore, poverty because of illness is in an increasingly serious situation, and the health gap between urban and rural is being widen.The new rural cooperative medical system (NCMS), which was launched in rural areas since2003, is designed to relieve rural residents’burdens, and increase their demand for medical services. This paper is to evaluate the effect of NCMS through studying the impact of NCMS on farmers’ medical services utilization, and find the way to improve the utilization of medical services in rural areas and release the famers’ financial burden due to catastrophic disease. This study has important theoretical and practical significance in improving the health status of rural residents, as well as contributes to further improve of NCMS.The whole paper is divided into five chapters. Chapter1is the preface, the background and meaning of topic chosen, the related concept definition, research methods and main content. Chapter2is the review of former research, which conducts a comprehensive overview of the research on the medical services utilization and medical system both home and abroad, then focuses on the research of NCMS impacting on medical services utilization. Chapter3introduces the new rural cooperative medical care scheme and its current performance in general. We select the macro data of the China Health Statistics Yearbook and National Health Services Survey Report, and apply the descriptive statistical method to analyze the situation of medical services utilization between urban and rural as well as different groups in rural areas, providing a realistic basis for the implementation and further development of NCMS. Through statistical analysis, we find that the level of medical services utilization of rural residents is still too low, while the medical costs continue to grow. Chapter4establishes the theoretical framework and proposes the related theoretical hypothesis. On this basis, we use the China Health and Nutrition Survey (CHNS) data and difference-in-difference (DID) method and propensity score matching (PSM) method to empirically analyze the impact of NCMS on rural residents’medical services utilization. The empirical results show that the implementation of NCMS does improve the level of rural residents’ medical services utilization, but not reduce their actual medical expenses. Chapter5shows the main findings of this paper, and proposes corresponding policies recommendations to achieve the further improvement and development of NCMS, and provide better health care services for rural residents.