The Investigation And Policy Research Of The New Rural Cooperative Medical Service In Poor Areas Of Yunnan Province

Objective:By surveying the New Rural Cooperative Medical System(NRCMS) in three counties of Yunnan Province learn more about the operation of NRCMS in poor areas of Yunnan Province, comprehensively evaluate the success and inadequacies when operating NRCMS, summarize the problems and the gained experience of the current new rural cooperative medical, identify the difficult and key issues of the implement NRCMS in the poor areas, put forward countermeasures and suggestions, provide a reference for the poverty-stricken areas NRCMS.Methods:This study is descriptive cross-sectional study. Using questionnaires collect such information as compensation plan, participation, fund-raising case, use of funds of three counties since 2007; individuals'in-depth interviews as well as focused group discussion were used to collect related information.Results:In 2009, rural per capita net income of the three counties are lower than the rural per capita net income of 3,369 yuan of Yunnan Province and are lower than rural per capita net national income of 5,000 yuan, are state-level Poor counties. In 2009, participation rate in three counties is over 90%, Luquan County is 95.22%, Daguan County is 91.46%, Yongping County is 92.19%, and three counties are all up to 100 yuan per capita funding standards. In 2007 to 2009, out-patient benefit rate of Luquan County were 64.91%,68.56%,93.35%; of Daguan County were 43.12%, 45.75%,157.15%; of Yongping County were 68.78%,77.02%,219.44%. In 2009, the average compensation of hospitalization is account rural per capita net income proportion, Luquan County is 24.81%, respectively Luquan County, Yongping County is 23.04%, Daguan County is 21.65%, to reduce the medical burden of farmers in certain extent. The average cost of outpatient is control well. The costs in village clinics level hospital were controlled less than 30 Yuan, the costs of outpatient in township level hospital were controlled less than 40 Yuan. The average compensation of hospitalization above the county level medical institutions are the highest proportion. Number of health institutions have basically reached all town have township hospitals, all village have village clinics. "It was not made" or "no one has compiled" is a common problem.Conclusions:Three counties to maintain a high level of participation in 2007 to 2009. Funding is in good condition, funding work should do well and establish long-term funding mechanism. The new rural cooperative funds of the three counties are stability. Compensation at all levels, the proportion of out-patient and meeting the actual compensation costs are lower, more conservative cost control. Recommends doing the work of propaganda and mobilization, improve out-patient utilization. Starting to develop a reasonable pay line, cap line and the compensation ratio of the standard, and gradually establish a perfect compensation program, to give financial difficulties of preferential policies to improve the fairness of the NRCMS. Strengthen the supervision of medical institutions to control the growth of medical expenses. To increase funding support to improve the management level of the NRCMS, strengthen capacity-building managers. Improve the rural health service system, strengthen the health team building, rational allocation of health resources. Increase the central government on the transfer payment to poor counties.