The Impact Of New Rural Cooperative System To Utilization Of Health Services And Benefit Distribution Among The Different Groups In Haiyuan And Yanchi Counties

Objective Analyze the impact of the New Rural Cooperative System to utilization ofhealth services, benefit distribution and the disease burden among the different groups inHaiyuan and Yanchi Cunties. Evaluate the effect of program, put forward reasonable andfeasible policy recommendations and as a reference basis for the formulation of health reformpolicy. Methods Make use of income five-packet method, the concentration index, theindex difference and so on, to analyze the fairness of health services utilization in outpatientand inpatient, benefit distribution and farmers’ economic burden. Adopt the MultivariateLogistic regression model to analyze the main factors of farmers’ health care utilization inoutpatient and inpatient. Results Two weeks attendance rates CI value of0.0039in2011iscloser to0than the CI value of0.0294in2009in Haiyuan County, out-patient health servicesis tend to fair.Two weeks attendance rates CI values are negative in surveys in Yanchi County,out-patient utilization of health services is mainly concentrated in the lower income group.The hospitalization rate of the CI values are negative in surveys in two Counties, in-patientutilization of health services is mainly concentrated in the lower income group, the maininstitutions of in-patient are still the county-level hospitals. The proportion of Outpatientcompensation is6.03%in2009, increased to47.53%in2011in Haiyuan County, and theproportion of inpatient compensation is49.27%, increased to78.04%. The proportion ofoutpatient compensation is13.15%, improve to52.74%in2011in Yanchi County, theproportion of inpatient compensation increased from67.85%to86.67%. The own averageexpense of out-patient services in2011costs less than237.15yuan in2009, in-patient services costs more than341.29yuan in Haiyuan County. The own average expense ofout-patient services in2011costs less than211.14yuan in2009, in-patient services costsmore than1163.92yuan in Yanchi County. The proportion of catastrophic health expendituresdropped by34.6%in2009to26.1%in2011in Haiyuan County, Yanchi County decreasedfrom30.2%to24.1%. Conclusion Since the implementation of the new program, thepotential demand for health services in low-income group of people to be released, theutilization of health services is overall better fairness, and there is an increasing trend,increased the utilization of health services of low-income people. The benefit distribution ismore evenly, low-income groups benefit more from the New Rural Cooperative System.Implementation of the new program play a certain role in reducing catastrophic healthincidence, but the costs of inpatient si growing too fast, farmers’ economic burden of diseaseis falling or not, need for further research. Proposed to enhance the service capacity ofprimary health care sector, efforts to resolve the pension insurance system of village doctorsand improve the income of them, and enhance the village health drugs with efforts to controlthe excessive growth of the hospital costs.