Variation Tendency And Intervention Effect In Health Services Demand And Utilization Of The Rural Women Of Childbearing Agein Ningxia

Objective Analysis changes of health services demand and utilization of the rural women of childbearing age;Evaluate the intervention effects of the project that named Innovative payment system,improve the health benefits..Methods By using the method of two stage stratified random sampling for the local resident women of childbearing age for household surveys in intervention counties and control in 2009,and following up the women of childbearing age in the 201 land 2O12.By comparing the intervention counties and control to evaluate intervention effect.Results 1.The average age of women of childbearing age is the 29.90±10.17 years old,and education at a lower level,More than 50% of primary school and illiteracy.Give priority to with NCMS insurance system.Urban and rural basic medical insurance to achieve full coverage; Self-rated health status at a good level.2.1n 2009,2011 and 2012,prevalence of two weeks were respectively 17.35%,13.06%,12.40%,appeared a downward trend;Prevalence of chronic diseases were respectively 10.04%,6.27%,10.98%,and there are significant difference;Prevalence of two weeks and prevalence of chronic diseases of different age groups,ethnic,education and marital status showed a significant difference.Compared intervention county with control,standardized rate of two weeks prevalence had no a significant difference in 2009,2011and 2012,standardized rate of prevalence of chronic diseases,on the contrary.3.The two weeks diseases which rural women of childbearing age suffering from were mainly concentrated in female genital diseases,acute nasopharyngitis and acute and chronic gastroenteritis;The chronic diseaseswere mainly concentrated in hypertension,at the same time,acute and chronic gastroenteritis,rheumatoid arthritis and gallstone disease and cholecystitis also among the top five.4.Two weeks outpatient visit rates showed a downward trend,yet patient visit rate showed a upward trend in 2009,2011 and 2012;During the investigating many patients changed their visit medical institution from county hospital to township hospitals and village clinics;The main reason for choosing visit medical institution is distance factor,the second is technical factors;No clinical visit rate is a declining trend,the first reason for no visit is economic difficulties,the second is feel mild disease;Hospitalization rates showed a downward trend,inpatient facilities gradually flow to at county level and below;No hospitalization rates showed a downward trend,not admitted to the hospital because of economic difficulties in first, followed by don’t have time.Compared intervention county with control,three years’ two-week outpatient visit rates no differences,.2012 year, patient visit rate of Intervention county higher than control,however,hospitalization rates of intervention county lower than control.5.The gynecological examination rate showed downward trend in 2009,2011 and 2012,but there is no significant difference;The prenatal examination rate,the pregnant early examination rate and the.hospital delivery rate all were upward trend;The postpartum visit rate showed a downward trend,and at a lower level.Three yeas the gynecological examination rate of intervention county were higher than control;2009 year,the hospital delivery rate of intervention county higher than control;2009 and 2011years,the postpartum visit rate of intervention county lower than control,but intervention county higher than control in 2012.Conclusions 1. Gradually increasing literacy level of the rural women of childbearing age and enhancing their self health care consciousness, has important significance to improve the health level of rural women of childbearing age,2.Two weeks prevalence of rural women of childbearing age decrease year by year, health level has improved, but it is very urgent to chronic disease prevention and control.3.Rural women of childbearing age two-week consultation rate decreased,and suggested outpatient health service utilization inadequate.4.The rate of postpartum visit are at a lower level,quality of pregnancy care services need to be improved.5.Health service utilization rate of intervention county is higher than the contol,showing that interventions are effective.6.Constantly improve and perfect the rural three-level network of medical and health care,strengthen the construction of basic health services, to further improve the level of health services is necessary.