Study On The Utilization Of Health Services For Patients With Key Chronic Diseases

With the economic and social development and the arrival of population aging,the ecological environment,lifestyle and eating habits faced by Chinese residents have changed greatly,and the number of chronic diseases is increasing.Due to the long duration of the disease,high treatment cost and high disability and death rate,chronic diseases cause great harm to the physical and mental health of patients and affect their daily life.At the same time,the whole treatment process of chronic diseases is a protracted war.During the treatment period,there will be treatment costs that are difficult for patients to afford.The loss of patients’ own labor force reduces their economic income and brings great economic pressure to patients’ families.The rapid rise in the cost of chronic disease treatment and the limited medical and health resources can not meet the growing health needs of the population.These issues directly related to the people’s livelihood have attracted great attention of the whole society.In this context,based on the definition of key chronic diseases by the national health and Health Committee,this paper takes hypertension and diabetes patients as the research object,and analyzes Maslow’s hierarchy of needs theory,Grossman health demand model and Anderson’s medical service utilization behavior model.By analyzing domestic and foreign literature and policies of chronic disease prevention and control in China,this paper establishes a framework for the research on the utilization of medical and health services for patients with chronic diseases.Using the methods of literature analysis,statistical analysis and comparative analysis,this paper studies the utilization of medical and health services for patients with key chronic diseases based on the data of China Health and elderly care follow-up survey in 2018(hereinafter referred to as Charles).The research conclusions are as follows:Firstly,through the analysis of chronic diseases and their prevention and control in China,it is found that the prevalence of chronic diseases among Chinese residents has increased year by year,and the prevalence among urban residents is higher than that among rural residents,and the prevalence among women is significantly higher than that among men,and the prevalence of chronic diseases among people aged 55 and over is higher.The new medical reform implemented in 2009 has strengthened the prevention and control of chronic diseases.For example,the basic medical insurance outpatient treatment policy for chronic diseases has been established,and the government has continuously strengthened the comprehensive prevention and control of chronic diseases.Secondly,the factors affecting the utilization of medical and health services for patients with key chronic diseases are diversified.According to Charles data,2452 samples of patients with key chronic diseases were selected.The factors affecting outpatient behavior include self-rated health status and age.The self-rated health status is poor,the age is small,and the probability of outpatient treatment is high.The factors affecting the hospitalization behavior of patients with chronic diseases include the number of hospitalizations,self-assessment of health status,age and type of medical insurance.The insured with more hospitalization times,poor self-rated health status,older age and non NCMS have a higher probability of hospitalization.Thirdly,the awareness of self prevention and health care of patients with key chronic diseases is poor.The study found that 48.41% of patients with hypertension had no physical examination in recent three years,40.7% of patients with abnormal blood glucose had no physical examination,and 42.06% of patients with hypertension and abnormal blood glucose had no physical examination in recent three years.It can be seen that their awareness of self prevention and health care is poor,which is mainly due to the poor economic status of patients with key chronic diseases,or the distance between medical institutions.The family residence of patients with key chronic diseases studied in this paper is about 21 kilometers away from the hospital.Fourthly,compared with other basic medical insurance,the utilization rate of inpatient services of key chronic patients participating in the new rural cooperative medical insurance is low.The sample size of patients with key chronic diseases participating in NCMS is the largest among several basic medical insurance,but the utilization rate of inpatient services is the lowest.Fifthly,the proportion of outpatient out of pocket expenses of patients with key chronic diseases is high,and the medical burden is heavy.The proportion of out-patient expenses paid by urban workers’ medical insurance participants reached70.7%,and the proportion of new rural cooperative medical insurance participants even reached 90%.This is due to the influence of compensation method,reimbursement scope,reimbursement proportion and reimbursement procedures,resulting in a relatively low reimbursement proportion of medical expenses of NCMS participants and a relatively high level of economic burden of patients.Finally,patients with key chronic diseases have high demand for grass-roots medical institutions.Due to the influence of distance,treatment time and other factors,in addition to general hospitals,most patients with key chronic diseases tend to choose the nearest township health centers or village clinics for treatment,and 32.35%of patients do not take treatment measures.Based on the above conclusions,the following suggestions are put forward:actively explore and establish an innovative management model for the whole process prevention and treatment of chronic diseases,carry out health education and health promotion activities,accelerate the urban-rural and interregional overall planning of the basic medical insurance system,improve the overall planning of outpatient services for urban and rural residents and other relevant policies,and strengthen the service capacity-building of grass-roots medical and health institutions.