Research On Rural Resident’s Satisfaction Of Local Health System Reform In Anhui Province

Objective This paper aims at studying the local health system reformimplementation status from the rural residents’ perspectives, and theirsatisfaction of the local health system reform in Anhui Province. By usingbasic information of rural residents and analyzing the influence factorsof rural residents’ satisfaction of the local health system reform. Thenit identifies effective methods to improve rural residents’ satisfactionof local health system reform, and provides references for propelling localhealth system reform further so as to better carry out the local publichospital reform.Method589objects were enrolled into this questionnaire by a multistage samplingmethod from12villages of Anhui Province，including Anqing, Wuhu, Chaohu,Hefei, Fuyang, Suzhou and other regions. A village was randomly selectedfrom a town, which was randomly selected from the6counties.6countieswere selected from south, middle and north Anhui Province. A total of600questionnaires were issued and589were collected, among which582werevalid. The recovery and effective rate was98.2%and97%respectively. Inthe investigation, all the investigators went to each pilot to know theactual local medical conditions, and made a face to face interview in personwith the informants to finish questionnaire according to their standard-designed questionnaire in batches. The data was designed and inputby the software of EpiData3.0, then analyzed by the SPSS18.0software.The relationship between rural residents’ satisfaction to the local healthsystem reform with different factors in Anhui Province was tested bychi-square test and logistic regression analysis.Result1.84.2%of the rural residents were satisfied with the local health systemreform currently. Satisfaction on the national essential drugs system wasrelatively high (79.6%), but satisfaction on the basic public healthservices was relatively low (63.6%).2.40.4%of respondents were aware of the local health system reform,54.2%of the respondents were not aware of the ongoing local health system reformwell;47.5%of respondents believed that the local health system reformhas brought tangible benefits to the phenomenon of “proper health careis difficult to get and expensive”, rural residents’ most concern of thelocal health system reform is the technical level of medical workers, andtheir second concern is the proportion and range of drug reimbursement.3. The influence factors of the rural residents’ satisfaction on the basicmedical security system are: types of medical security, proportion ofoutpatients’ and hospitalizations’ reimbursement and their satisfactionand convenience of reimbursement (P<0.05).4. The influence factors of the rural residents’ satisfaction on thegrass-roots health care services system are: convenience of getting healthservices, health-care workers’ technical and attitude (P<0.05).5. The influence factors of the rural residents’ satisfaction on thenational essential drugs system are: the prices change of drugs, whether the essential drugs meet patients’ demands and the situation of buyingmedicine from private pharmacies (P<0.05).6. The influence factors of the rural residents’ satisfaction on the basicpublic health service are: the situation of providing public health(P<0.05).ConclusionThrough the implementation of the local health system reform, the ruralresidents’ satisfaction on the health care system improved in AnhuiProvince, but there still exist some shortages, the followingrecommendations are made:1. The basic medical security system: to take measures to improve the actualreimbursement ratio of outpatients and hospitalizations; to reduce ruralresidents’ burden of disease and actual benefit them.2. The grass-roots health care services system: improve the basic medicaland health service system through improve diagnosis and treatment skills;to optimize the team construction of local health institutions’ healthstaff and strengthen their capacities of health services.3. The national essential drugs system: to add directory of essential drugs,to improve the mechanism of drug delivery and actual lower drugs’ priceto meet rural residents’ medication needs.4. The basic public health services: to perfect health records; to enrichhealth education content.