Analysis Of New Rural Cooperative Scheme And Its Effect On Alleviating Poverty Caused By Illness In Jinzhai County,Anhui Province

BackgroundThe eradication of poverty is an urgent requirement for the sustainable development of all countries,especially the developing countries.Since the 18 th National Congress of the Communist Party of China,the status of poverty-stricken areas in China has changed a lot,and the living standards of the poor have been significantly improved.However,despite the success of China's poverty alleviation,this work still has a long way to go.Jinzhai county in Anhui province is a famous revolutionary old district and a key poverty-stricken county,as well.In order to help lift out of poverty,our university has undertaken the task of helping Zishu village of jinzhai county.At present,few researches focus on the implementation effect of medical insurance policies in poor areas,and the health poverty alleviation work needs data support.ObjectivesThis study closely combined with the background of national precise policy for poverty alleviation and health poverty alleviation program,and the poor areas due to illness was especially targeted.This paper compared the operation of New Rural Cooperative Medical Scheme(NCMS)in Jinzhai county,Anhui province from 2012 to 2016 through data analysis.In the comprehensive objective evaluation of medical insurance policy implementation effect and the findings of the deficiency,relevant policy suggestions were put forward accordingly,to provide scientific decision basis for the policy.Methods1.Data source: The data was from statistical yearbook information,social development statistical bulletin,database of cooperative medical center of Jinzhai county and field research.2.Methods: The experience of health care policies and practices for the poor or low-income groups at home and abroad were studied with literature review.Descriptive analysis was used to analyze the data of NCMS and Critical Illness Insurance in jinzhai county.The influence factors of medical insurance cost were analyzed by Mann-Whitney U test K-W test and multivariate linear regression.Times Series Model was used to predict the future cost of NCMS.Through field investigation and means of Chi-square test,the health status of rural residents and the implementation effect of medical insurance policy were analyzed.Results1.Overall,the total financing and expenditure and benefit population were on the rise in the year 2012-2016.The number of male patients participating NCMS was slightly higher than female in the year 2012-2015.The age distribution of reimbursement was U-shaped.The proportion of patients who chose village clinics or township hospitals increased year by year,while the proportion choosing the county hospital,city hospital or out of city hospitals decreased.2.In terms of the average cost,the total cost of medical treatment,pharmaceutical cost and compensation decreased in 2012-2016.The compensation ratio in 2016 was lower than that in 2012.Main disease,like cerebral infarction,pneumonia,chronic nephritis,hypertension and gastritis,pointed out the direction for the key development of medical institutions in the county.3.In terms of the cost influencing factors,the cost was related to age and the medical institution.According to the minimum principle of root-mean-square error,the SPSS expert simulator established the winters addition model for each cost.The forecast results showed that the future hospitalization expenses were on the rise,indicating that hospitalization expense control should be taken seriously.4.In terms of the effect of poverty alleviation,compared with 2012,the poverty rate was reduced in 2016.The reduction of the total gap was obvious in 2016.The average gap before compensation is increasing year by year.After compensation,the average gap in 2016 was lower than that in 2015.5.The residents in sample area were mostly left-behind old people,with low level of education,and the proportion in the normal BMI range was lower than that of the central rural average.The proportion of residents' health expenditure to total expenditure was high.The rural population did not understand the medical insurance policy,such as NCMS and critical illness insurance,indicating that the effect of policy propaganda needs to be improved.6.In terms of health service demand and utilization,the prevalence rate of two-week and chronic disease and hospitalization rate in the sample area were higher than the central rural average.The two-week illnesses were mainly digestive and cardiovascular diseases,while the hospitalization illness was principally cardiovascular diseases.The respondents mostly chose the medical institutions in their own county.After compensation,the rate of poverty caused by illness among hospitalized patients was halved,which manifests that the insurance policy has made difference on the poverty alleviation effect.Conclusion and Suggestions1.The government should not only improve the legal construction of medical care,but also increase input.Policy propaganda can be implemented by the local health staff in order to make it into practice.2.The medical insurance financing access should be expanded with settlement and payment reform.Besides,the pay-by-disease system should be established and the number of clinical pathways should be increased.Moreover,the information database for the poverty should be built to provide more accurate management for the health care of the poor.3.The county medical institutions should focus on common diseases and actively enhance the medical treatment ability.The medical team should be sent regularly to the poor village to strengthen the medical service capacity of rural integrated outpatient service.4.The rural left-behind elderly health problems deserve more attention.Health education need to be carried out to improve the awareness of health and chronic disease management in rural areas.