Study On Influence Of Hospitalization Expenditure And Health Seeking Behavior Of NCMS In Fujian, China

Objective:To study the impact of NCMS on hospitalization expenditure and health seeking behavior,investigate the effect of NCMS on resolving the problem of inadequate and overly expensivemedical services, the problems existed and farmer’s opinion and suggestions for improving theNCMS in Fujian.Methods:To analyze hospitalization database and hospitalization compensation indicators from2004to2012in Fujian, analyze the data of statistical survey tables from every counties andquestionnaires from farmers by description of the indicators for finding the influence factorsof NCMS on medical burden and health seeking behaviors of farmers by using SPSS V.15package.Result:①Times hospitalization charges were from RMB3151Yuan to5375and the growth ratewas70.6%from2004to2012；and times amount of compensation was from934to2546andthe growth rate was172.6%；the actual compensation ratio was from29.60%to47.31%.The adjustment index of times hospitalization charges was decreasing from0.54to0.29withthe increasing of farmer income per capita and showing some difference in different counties.②The cases with ultra-high hospitalization chargeswere increasing with year in the past five years and the growth rate was42.1%. Although theadjustment index of times hospitalization charges was decreasing, but the mean pockethospitalization payment was still27.3times the per capita income of farmers in2012, even thevalue was the lowest one in the past five year.③The case percentage of hospitalization out ofthe county was increasing from22.1%in2004to more than30%in2012and the total hospitalcharge accounted for62.57%.④The main influence factors of times hospitalizationexpenditure were analyzed and summarized as follows: followed by treatment in the hospitalsout of county, hospitalization at county level, pocket drugs charges and other pocket costs. Themain influence factors of actual compensation ratio were as follows: fund-collecting amount percapita，treatment in the hospitals out of county, hospitalization at county level, and non-compensatory ratio. Conclusions:Times hospitalization charges of the NCMS cases were increasing with years. The timesamount of compensation and actual compensation ratio were increasing too, with the increasingof fund-collecting amount per capita. Then, the adjustment index of times hospitalizationcharges was decreasing, the medical burden of the farmers is still heavy.The case percentage of hospitalization out of the county was increasing in recent years,rsulting in the growth of times hospitalization charge, restricting the growth of actualcompensation ratio. It is suggested that the hospitalization charge should be controled, the fund-collecting amount per capita and the survice skill of the hospital doctors at lower level shouldbe increased, the management of drug lists of basical and NCMS should be strengthen，theragulations of case referral according to hospital levels and additional compensation for thecases with ultra-high hospitalization charges should be carried out for improveing theeffectiveness of NCMS.