Changes In Health Services Utilization And Medical Expenses Of The Urban And Rural Elderly In Chongqing

ObjectivesOn the study of the changes in health services utilization and medical expenses of urban and rural elderly in Chongqing from 2008 to 2013 based on the comparison between urban and rural areas, analyzing the conditions of elderly in different age groups,to understand the utilization gap between urban and rural elderly deeply,and to analysis the influence of medical reform policy on health services utilization of elderly,and to provide positive and scientific suggestions for further improvement of health services utilization equity of urban and rural elderly,health condition of elderly and for reducing the medical burden.Materials and MethodsThe materials of the study is from the fourth and fifth research on health services in the western part of China in 2008 and 2013.The samples of two health services survey follow the sampling principle of economicefficiency,extracted by multistage stratified cluster random sampling method. After the screening based on age to meet the need of research,10331 elderly residents aged 60 and above participated in this research.Literature research method,comparative method and panel discussion method were used to study the changes in urban and rural health services utilization and medical expenses,and descriptive statistics, chi-square and multiple stepwise regression model were used to statistical analysis the data.ResultFrom 2008 to 2013,the hospitalization utilization rate of urban and rural elderly in Chongqing increased significantly,more significant for oldest-old, low-income population and patients with chronic diseases;The coverage ratio of basic medical insurance widen further,the self-paid ratio of hospitalization expenses of urban and rural elderly decreased sharply;The choice for outpatient and inpatient institutions of urban and rural elderly inclined to basic-level institutions,and the flow direction of seeking medical service tended to be more reasonable.There are many problems in urban and rural elderly health services utilization and medical expenditure at present: 1.The health services of urban and rural elderly is in a state of “ high need,low demand ”; 2.The differences of income and system cause unfairness in urban and rural elderly health services utilization; 3.Urban and rural elderly medicalexpenses increased rapidly,medical economy burden of rural elderly and oldest-old is very heavy; 4. The prevalence rate of chronic diseases is high,and it becomes a important factor harming elderly health.SuggestionsTo solve above problems,the corresponding solutions are proposed:1.Increase spending on the health services, and gradually improve the elderly health care system; 2.Enrich the connotation of medical unified planning, explore and construct medical insurance which is suitable for the elderly; 3.Perfect endowment insurance and social assistance system,gradually narrow the utilization gap caused by income gap; 4.Take effective measures to reduce medical burden of urban and rural elderly,pay special attention to rural elderly and oldest-old; 5.Strengthen urban and rural elderly chronic diseases prevention,promote healthy aging.