Comparative Analysis Of The Cost And Utility Of Different Combination Of Medical And Health Care Models

Objective:This study is based on the investigation of Jiangsu Province,from the perspective of health economics,on the basis of theoretical analysis,through in-depth research to assess the cost of different models of combination of medical and health care and explore the factors influencing the cost of combination of medical and health care models,and the way of combination of medical and health care models,to understand the needs and willingness of the elderly to adopt the combination of medical and health care service,and through EQ-5D scale to obtain the quality of life of the elderly,and then based on the Chinese TTO integral conversion system to calculate its effectiveness,and analyze its cost-effectiveness.Methods:This research investigated 516 elderly people in three districts,Suzhou,Nanjing and Zhenjiang,adopting the rate ratio calculation,chi square test and many more to describe the basic situation of the elderly.The chi-square test was used to evaluate the choice of the two models,logistic regression of the selection of the two models is carried out,the factors influencing the cost of the two models are analyzed by multiple stepwise regression analysis,finally,the cost-utility analysis method is used to compare the cost utility of the two models.Results:(1)Women tend to choose the community home model for the elderly,the lower age of the elderly in the older age of the elderly are more inclined to choose the community home model,the elderly suffering from less chronic diseases tend to choose the community home model,completely self-care elderly more likely to choose the community home model,Spouse health in the elderly are more inclined to choose the community home model,low education level of the elderly than the high level of education of the elderly are more inclined to choose the community home model,work in general and no work tend to choose the community home model,low income groups tend to choose the community home model,income from others tend to choose the community home model,rural elderly tend to choose the community home model,other types of insurance for the elderly than the urban workers in the health insurance of the elderly tend to choose the community home model,the more the number of children tend to choose the community home model.(2)Combination of medical and health care model is not satisfactory,empty nest elderly,living alone accounted for a large proportion of the elderly.(3)Retirement community home care costs less than institutional care,pension costs unaffordable.(4)The elderly expect to choose the community home model,looking forward to the introduction of Chinese medicine health care projects.(5)The factors influencing the cost of the model are the residence,age,the number of chronic diseases,the number of children,the costs of the elderly in urban areas are higher than those of the elderly in rural areas;the older the age,the higher the cost;the more the number of chronic diseases,the higher the cost;the smaller the number of children,the higher the cost.(6)The cost-effectiveness of community home model is higher than that of institution.Conclusions:(1)The current situation of combination of medical and health care model is not optimistic.(2)The elderly can not afford the cost of combination of medical and health care model.(3)A variety of factors affect the choice of combination of medical and health care model.(4)The cost-effectiveness ratio of combination of medical and health care model is low.(5)Elderly people expect community home model and have strong demand for health care of traditional Chinese medicine.Recommendations:(1)Develop the care service path of combination of medical and health care model to achieve coordination and cooperation at all levels.(2)Advocate community home model to reduce the burden on the aged.(3)Make up the shortage of talent and build up a multidisciplinary team.(4)Improve the long-term care insurance system,the information system and customer classification system.(5)Adopt wearable equipment and Chinese medicine health care project,and pay equal attention to both traditional Chinese medicine and Western Medicine.(6)Pay attention to the elderly spiritual world and provide humanistic care.