Shanxi Province, The New Rural Cooperative Medical Care System, "serious Illness" As Defined In The Theoretical Discussion

Objective: To criterion study the boundary "high expense disease" about the new pattern Cooperrative medical system. Method: Health, health care utilization and expenses about the inhabitants are studied with the transect investigation in the area. To ration study the high expense disease with the method about disease economic risk. With the method about hospitalize risk critical limit bound "high expense disease". With the method about family catastrophic health payments bound "high expense disease". Results: The culture level of the peasants is relatively low and the gap among income of theirs is wide in investigation area. The two week sicken rate and chronic disease sicken rate are higher than the one of the third countrywide health care investigation and inclined increasingly with the increasing of family's income. On the level of medical treatment institution, outpatients concentrate the hospitals in villages and towns and health service institution in village, while inpatients concentrate the hospitals in villages and towns and county hospitals. Along with the increasing of family's income, the ratio between the medicine payout of one year and family's total payout decline. Economic risk in the inpatients is the highest and that of chronic disease sufferers take second place in investigated populations. Along with the increasing of family's income, disease economic risk declines increasingly, that is to say, the lower income familys are confronted with higher disease economic risk. Disease economic risk of the lowest income group is 6.39 times with that of the highest income group. On the level of medical treatment institution, economic risk is increase with the advance of level of institution. Therefore the disease economic risk concentrate mostly the inpatients, the lower income population and the advanced level medicine institution. The total hospitalize risk critical limit with personality is 737.02 yuan and that with family is 2977.56 yuan. The percentage of family under hospitalize risk critical limit is 14.56% and that of personality is 5.95%. In order to reduce difference of population's income, removing the population with zero payment capacity, the other persons are divided 5group and hospitalize risk critical limit of each group with personality is 405.80yuan, 518.48yuan, 702.76yuan, 931.72yuan, 1619.43yuan and that with family is 1444.65yuan,2156.86yuan,2796.98yuan,3959.81yuan,7028.35yuan. Catastrophic payment headcount, mean catastrophic payment gap and mean positive gap decline with increasing of boundary standard. When boundary standard is 40%, catastrophic payment headcount is 25.5%, while when boundary standard is 60%, catastrophic payment headcount is 14.85%. Conclusion: The boundary "high expense disease" is expenses of 1500yuan and upwards of a family in one year. The disease economic risk concentrate mostly the inpatients, the lower income populations and the advanced level medicine institution in investigation area. Compensation pattern of high expense disease should incline the inpatients and the lower income populations and population hospitalize flow need to be inducted in reason. The method about hospitalize risk critical limit is fitter to bound "high expense disease" than the method about family catastrophic health payments be.