Medical Service Status Quo And Remedies For Urban Residents Entitled To Basic Living Allowances

Objective:(1) To provide the basis for the improvement of health services demand for residents entitled to basic living allowances and supply references for relevant departments to formulate social health remedies and measures.(2)To Provide nuts-and-bolts improvement suggestions and services measures for medical servicesMethods:(1) The patients entitled to basic living allowance hospitalizing in designated hospitals in Kuancheng District Changchun City in 2008 were taken as the research objects, and the contemporary inpatients who participate urban hospitalization insurance were taken as control. Through computer hospitalization settlement system, hospitalization situation and expenses information of inpatients and referrals entitled to basic living allowance and inpatients who participated urban medical were checked, the case information was classified according to ICD-10 with the classification of disease conducted by the first diagnosis.(2) Collect 200 residents entitled to basic living allowance as the informants according to the proportion of 9 subdistricts and 1 township within the jurisdiction of Kuancheng District. The research includes general natural conditions, health services demand, health services utilization, hospitalized situation and their knowledgement of policy, etc.Statistics analysis:Complete and accurate data available and field survey data were collected to sort out and input the information into Excel to establish the database by double input method. Check strictly and conduct statistical analysis for data using SAS8.02 software. Qualitative data was inspected byâ…¹2 and non-normal data was inspected using rank-sum test. Results:(1) Male inpatients entitled to basic living allowance are more than females in Kuancheng District, with the proportions of male and female inpatients are 55.19% and 44.81% respectively. The top 5 systematic classifications of the disease suffered are tumors, circulation system, digestive system, genitourinary system and respiratory system, with the proportion far higher than urban residents; the average hospitalization expenditure, average reimbursement expenses and the proportions of death are higher than those of urban residents with the exact figures of 3127.68 Yuan, 1908.23 Yuan,and 66.67%. The main reason of referral is technical problems which account to 62.09%.(2) Two-week morbidity rate, two-week treatment rate, two-week bedfast rate, chronic disease morbidity rate of the urban residents entitled to basic living allowance are 62.0%, 70.16%, 36.0% and 82.5% respectively. The hospitalization rate for serious disease in the previous year surveyed was 35.5%; the main reason for them to leave hospital was financial difficulties. The treatment principles for those residents receiving lowest costs of living are they don't treat small diseases but serious disease and they try to delay the treatment with the proportions are 35.0% and 34.0% respectively. The community hospital accounts highest proportion of 60.5% for consultation rate, 33.5% of residents receiving lowest costs of living don't know subsistence allowance policy.Conclusion:(1) Middle-aged inpatients entitled to basic living allowance has higher proportion in Kuancheng District. The top 5 systematic classifications of the disease suffered are tumors, circulation system, digestive system, genitourinary system and respiratory system, with the proportion far higher than urban residents.(2) The average hospitalization expenditure, average reimbursement expenses and the proportions of death of middle-aged inpatients entitled to basic living allowance are higher than those of urban residents.(3) Two-week morbidity rate, two-week treatment rate, two-week bedfast rate, chronic disease morbidity rate and hospitalization rate in the urban residents entitled to basic living allowance are all very high, they leave hospital due mainly to their financial difficulties.(4) Corresponding policies proposed for difficulty in visiting a doctor for some low households among urban residents.â‘ To improve medical rescue system.â‘¡To promote the reform for medical insurance system and to enlarge its coverage.â‘¢To stabilize subsistence allowance policy and to speed up the legal construction for minimum living standard system.â‘£To pay attention to the health care for people who are in minimum living standard and to bring community into full play.(5) Improving suggestions and services measures proposed to aim at the medical treatment services in medical service organizations.â‘ To build the network service information system and to implement the system in which patients are able to select doctors as they like.â‘¡To strengthen the training for general practitioners.â‘¢To improve services and to carry out relevant measures.â‘£To reinforce the supervision to hospitals and to maintain regular operation of medical treatment.