Shenyang And Chengdu City Poor Medical Assistance Mechanism For Evaluation Studies

With the deepening of China's reform and the rapid transition of social-economic pattern, the urban poverty is becoming more and more manifest. By the end of 2003, the system for ensuring a minimum standard of living, on the whole, achieved the goal of assuring all those should be assured, covering 22.468 million urban poor people. However, the health status of the poor is very bad with a low-level health service utilization, whose main influencing factors are financing difficulty and lack of medical insurance. Seeking doctors for poor families are still quite difficult.Chinese government is paying much attention to urban poor residents' medical security, definitely ordering to explore to establish urban poverty medical assistance fund(MAF) system. Recent years, in Beijing, Shanghai, Guangzhou, Dalian, Qingdao, etc, the government-dominated and relatively normative urban MAF systems for serious diseases have been established; however, for the whole country, the MAF work is just at the very outset. In 2003, Chinese and British governments launched a three-year Urban Health and Poverty Project (UHPP) in Chengdu and Shenyang to supply medical assistance fund(MAF) to urban poor people. They hoped to explore a MAF system with good maneuverability and cost-effectiveness.This research makes a general and systematical analysis and evaluation on the UHPP program carried out in Chengdu and Shenyang from the dimensions of input, process and outcome. The concrete research purposes include: 1) evaluate and analyze the operation of the MAF program based on the process of supplying MAF service and the utilization of MAF service; 2) focusing on the poor people's access to health service and the changes of medical burdens, evaluate the effects of the MAF program, and analyze the related factors that influenced the utilization; 3) evaluate the innovative experiences of MAF mechanism in the UHPP program from the dimension of policy, and then bring forward the direction and main strategies for the development of MAF policy.Through this evaluation research, we will sum up the experiences, find some problems and put forward related suggestions, supplying scientific proofs of further perfecting the UHPP MAF mechanism, and also benefiting other areas which will carry out MAF programs. Accordingly, whether in theory or from the practical application, this research is a pioneering study, and of great research value.In this study, the evaluation on the MAF mechanism was arranged as followed: first, program evaluation theories were used to evaluate and analyze the function modules of UHPP MAF, i.e. firstly analyze the specific mechanisms of MAF, such as the identifying of beneficiaries, the propagandizing, the package designing, the appointed organizations' admission, supervising, etc. And then, a general, further discussion and...