Analysis On The Effect Of Rural Medical Assistance

ObjectivesThis study is to find out main problems in the policy implementation,explore key factors affecting policy implementation and provide some suggestions by analyzing the status and effectiveness of Rural Medical Assistance(RMA).Then it is favorable for establishing RMA with reasonable management and normative execution.MethodsLiterature review:reviewed related documents to command research methods, index and framework for analyzing,then know about the history,background for RMA and other institutions such as New Cooperative Medical Schemes(NCMS)and Dibao.Beneficiary investigation:sampled three counties typically from east,middle and west districts(A in Anhui province,B in Hubei province and C in Qinghai province),then sampled three townships from each county typically according to natural status(plain,foothill or mountain),geography distribution,economic level, then sampled three villages for each township randomly.In each village,we investigated three to five beneficiary families by accident.Totally 101 households (348 beneficiaries)were investigated.The contents included age,education level, health status,medical security covered,net income,medical expenditure,cognition rate and evaluation on medical assistance.Key informants interview:We interviewed national section chief of MOCA to know about the backgrounds,status and development trends for national RMA.We interviewed section chief of MA at county level to know about the status,problems of MA and personal suggestions for improving MA.The deans of pilot hospital were interviewed for knowing about their thoughts on MA,measures and personal suggestions for improving MA.Institutes investigation:We visited Civil Affairs bureau and collected some data such as socio-economic status,rural Dibao and Wubao scale and criterion,RMA documents and RMA financing,expenditure and utilization.We also visited NCMS bureau to collect documnets,report forms,and got outpatients expenditure each time on average and hospitalization expenditure each time on average.Statistical methods:Chi-square test was used for coverage rate,linkage rate and beneficiary rate among three counties.The software was SPSS 13.0 Version.Procedure analysis:It was to find out key factors affecting effectiveness of MA, by analyzing funds raising,utilization and management.ResultThe coverage rates were all 100%for three counties.The linkage rate was 2.96%,2.38%and 1.90%respectively,and the difference among three counties was meaningful statistically by Chi-square test(P=0.0009).The beneficiary rate was 2.4%, 0.8%and 2.1%respectively for three counties,and the difference was meaningful statistically by Chi-square test(P=0.0008).The beneficiary rate for "Youfu" was the highest.The real compensation rate was 29.1%,62.8%and 22.3%respectively,and the expenditure out of pocket was 2581.0 Yuan,744.2 Yuan and 2427.9 Yuan.The recognition rate was 45.7%,22.7%and 60.0%.39%of the beneficiary thought MA was very helpful,44%thought it was helpful in a certain degree and 17%thought it was a little helpful.ConclusionsIt was in 2003 that RMA started,and it covered all the counties basically in 2006.It was the first RMA in the history that was government financing mainly,for all the rural citizens and implementing independently.It implemented more and more institutionally.In 2006,it covered all the Wubao,Dibao and other poor citizens,and relieved economic burden of illness as well as reduced the poor rate resulting from illness.But because of low level financing,irrational funds distribution ways,complex procedures and lack of experiences,the effectiveness should be improved future.