An Investigation Into Peasants' Knowledge And Evaluation Of New-type Rural Cooperative Medical System (nrcms)

Objective To explore the Houma City peasants' cognition, participation, evaluation of new-type rural cooperative medical system (new-type rural CMS), to sum up the factors influencing the system and to dissect the existing problem, to put forward feasible proposals accelerating the sustainable development of new-type rural CMS on the basis of questionnaire and spot field investigation about the operation situation of new-type rural CMS in Houma City.Methods Choosing 20 students from anesthesia department of Shanxi Medical University in 2007 and 2008 to do questionnaires. Farm families are respondents.Using random sampling method. Research content mainly includes six aspects (1) general situation(gender, age, education, income, etc.)(2) health needs and utilization of the farmers (health, medical frequency, the processing method and medical expenditures) (3) awareness of NCMS(overall awareness, awareness ways and ideal ways)(4) the participation of NCMS (participation rate, participation ways and influence factors)(5) the farmers' satisfaction of NCMS (including the satisfaction of the fund management mode, fund management,reimbursement ratio, compensation scale and designated medical institution (6) multi-factor analysis of Farmers' satisfaction of NCMS.After verification of questionnaire, typing the datas using Data3.0 Epi software in double machine, usingSPSS11.5 software for statistical analysis.Results (1)providing 2541questionnaires,and taking back effective 2495 questionnaire, total effective rate was 98.2%.(2) health needs and utilization of the farmers farms surveyed felt that 27.1% was very good 51.5% was in common condition,10.8% was not too good, and 10.6% was poor.83.7% farmers would do physical check-up after being ill,10.6% never do and only 5.7% do it every year; treatment methods after illness was different; the ailment Every medical expenses< 500 yuan was 47.5%,500-1000 yuan was 34.5%,1000-2000 yuan was 14.5%,> 2000 yuan of 3.5%,51.5% of the farmers has chronic illness patient at home.(3) awareness of NCMS the overall awareness rate was 95.3%, the awareness rates of Financing mode, fund management, reimbursement ratio, compensation scale, the medical establishment are 50.6%,40.1%,57.1%,48.8%,50.8%, the farmers knewn NCMS policy mainly by village propaganda. (4) the participation of NCMS the participation rate of NCMS is 94.1%, as for participation ways, voluntary participation is 58.3%, going with the stream is 24.7%; 42.1% of the farmers worried about the low reimbursement ratio and the high threshold fee,23.1% of them worried about the high prescription charge and cheching expenses. (5) the farmers' satisfaction of NCMS 86.3% of the farmers thought that the fee was appropriate, the satisfaction rates of the fund management mode,reimbursement ratio, compensation scale are36.7%,31.5%,45.2%, the satisfaction rates of the medical establishment institutions of the village,county,city are42.6%,56.9,61.1%. (6) multi-factor analysis of Farmers' satisfaction of NCMS farmers' culture, health, medical expenses, financing mode satisfaction, reimbursement ratio satisfaction, compensation scale satisfaction and medical institutions are relate to the farmers' satisfaction of NCMS (P< 0.05).Conclusion 1.farmers health risk was big, the existing prevention concept need improve, Suggesting to increase compensation rate and the out patient expense proportion of chronic diseases.2. the awareness rates of Financing mode, fund management, reimbursement ratio, compensation scale, the medical establishment are low. Do other media publicity such as television, radio, newspapers and designated medical institution, improve farmers NCMS's popularity, increase the quantity, improving farmers to continue to join the confidence.3.the voluntary participation rate of NCMS was low. To increase reimbursement ratio, reduce cost, the establishment and threshold combining new rural cooperative medical care system, regulate medical institutions' operation,and add up NCMS benefited range.4. to formulate rational individual fee, make scientific financing mode, to increase the fund, bring more benefit to farmers.5. the satisfaction rate of the fund management mode is low. The local government should improve the fund management and supervision mechanism, and each country should made the village contents public,accept regular and implementing supervision, admit the villagers'participation and increase its transparency.6. the satisfaction rates of reimbursement ratio, compensation scale are low. The local government should establish reasonable compensation system, improve the simplicity, expand the scope of proportion of compensation,and reduce the farmer compensate pays proportion,7, the satisfaction rates of different medical institutions are not the same. The health administrative department should distribute health resources reasonablely, strengthen the levels of the medical establishment, strengthen the supervision of infrastructure construction, control the medical fees strictly.