Study On Health Financing Equity In Rural Dali Of Yunnan Province

ObjectiveThrough the investigation of the family economic conditions, health expenditure and health service utilization situation, to measure and evaluate the fairness of health financing and the progressive of channel for financing of health by using the WHO and the European Union health financing Fairness Evaluation Indexes. Factors influencing the family catastrophic health payments were analyzed to understand the equity of health financing of rural residents in Dali. Explore the way to improve the equity of health financing.Materials and MethodsStratified random cluster sampling was used to selected sample according to the economic developmental conditions among counties in Dali rural area. The total number of rural families in the survey is3697in three counties. Data collected included family income and expenditure in detail, and health expenditure for health care utilization and health insurance. Data was entered database of Epidata and analyzed using SPSS and Excel software. Indices were used in the analysis including family health financing contribution rate (HFC), the index of Fairnness for Financial Contribution (FFC), Kakwani index, family health financing Lorenz Curves, and ratio of families which had catastrophic health payments. The statistical methods used in analysis Logistic included Chi-square test, Logistic regression.Results(1) In sample household expenditure, health expenditure accounted for17.21%, ranked second, food expenditure accounted for only2.76%, ranks eighth.(2)Health financing structure indicate, in household health expenditure, the proportion reached63.81%, Government health spending accounted for33.10%.(3) Index of fairness of Financial Contribution (FFC) measurements, show the whole sample population’s FFC is0.51,in low level; in accordance with the family ATP10equal division of the family FFC is in the range of0.23-0.78, the ATP increased, FFC decreased.,namely the ability to pay low intra population fairness than ability to pay high the crowd. In three cities, FFC for a maximum of0.61with Midu, the minimum is0.49with Weishan.(4) Through the different payment ability groups, low paying capacity crowd of family health spending relative to their payment capacity is too large,their health financing burden is heavy, and the high ability to pay the crowd health financing burden is light.(5)The rate of family catastrophic health expenditure is high percengtage of37.41%,In three cities,45.34% is hightest with Weishan,26.29% is lowest with Dali and40.43% in Midu, three compared and ATP group were also statistically significant.Selected six risk factors in Logistic regression.there are the family population scale,income,health expenditure,and whether have older that more than60s’,chronic patient and Hospitalized patients.(6) In the analysis of channel progressive health financing, through Kakwani index and Lorenz curve, four kinds of financing channels showed negtive in objects.Conclusion From research, to improve the equity in health financing situation not only to crease the expenditure of government on health, on the other hand, family health financing levels should also be improved to a certain extent, but should pay attention to the different ability to pay people have different pay health financing costs through encourage the reasonable consumption structure, eg:reduce tobacco, human consumption to improve the quality of life and safeguard the health of family members.