Research On The Medical Care Security System Of Regional Urban And Rural Coordination

Objective:China has gradually set up four medical care security systems (MCSS) which are the basic medical insurance system for urban workers, the new rural cooperative medical system, the pilot basic medical insurance system for urban residents and the urban and rural medical assistance system after 30 years of exploration since the reform and open. However, many profound lessons have been left due to lack of experience, unclear ideas and decision-making misplay. It is objective needs and future development of long-term planning that have shown the urgent need for China to generally plan a MCSS in the new era with Chinese characteristics covering urban and rural residents, sound and unified. This study aims to explore the co-ordination between elements of urban and rural medical care security system and build theoretical framework of the basic medical care security system of urban and rural coordination based on research of urban and rural coordination and theory of MCSS and supported by status of MCSS, through the analysis of the source and deficiencies of urban and rural medical care security system.Methods:1. Literature analysis. Relevant literature at home and abroad was gathered by appropriate retrieval strategy, and research results on urban and rural medical security system were summarized through extensive reading. 2. Normative analysis. Logical analysis was used to analyze the collected documents by the theories of public policy, economics, management science, ethics and other related theories to explore ways to narrow the gap between urban and rural MCSS. 3. Empirical study. Empirical research was conducted in Chongqing where the exploration of medical security of urban and rural coordination is ongoing, and its initial results were summarized, the existing issues were analyzed and proposals for reform were made. 4. Interview. In-depth interviews were conducted to government representatives involved in the design of the security system and experts of the relevant research field to learn about the background of the system designs and the potential information that can not reflected from the data. 5. Comparative analysis. Differences were compared between elements of urban and rural MCSS before and after the coordination and the unfair connotation expressed in systems was analyzed with the collected information.Results:1. Research on medical security theory. Government responsibility in medical care security was expounded from the point of economics view; concepts and theories about equity and fairness were analyzed, and the support systems of medical security theory were systematically analyzed which included external effect and public goods theory, equity and efficiency theory, information economics theory and so on. 2. Research on the development of medical care security integration abroad. The background and development trend of modern medical care security were analyzed, and the model of modern MCSS was expounded, the experience and opportunity selection of urban and rural medical care security integration in the developed countries and regions were analyzed. 3. Reflection on the dilemma of China's binary MCSS. The political and economic background of the establishment of China's MCSS was analyzed, and the formation, characteristics and hazards of the binary MCSS was also analyzed. 4. Urban and rural coordination theory and its application in medical care security. The basic theory of urban and rural coordination was systematically analyzed, and pacing factors and constraints to achieve medical care security of urban and rural coordination in our country were investigated. 5. Empirical research on the pilot districts that explore the. Initial achievements were summarized, and the problems were identified and improvement measures were proposed. 6. Construction of MCSS theoretical framework of medical care security system of urban and rural coordination. The goal and basic principles of MCSS of urban and rural coordination and the four basic relations needed to be properly handled were proposed, and steps and measures to establish coordinating urban and rural medical care security system were drew off.Conclusion:1.The formation and consolidation of the binary MCSS in urban and rural areas in our country has profound reasons. 2. Binary urban and rural medical care security system impairs social justice and affects social stability. 3. Developed countries and regions set up MCSS covering all citizens and urban and rural integration in order to eliminate social inequality and resolve social conflicts in their mid-and late industrialization. 4. China has initially possessed the fundamental condition to achieve basic medical care security of urban and rural coordination. 5. Some restricting factors still exist in MCSS of urban and rural coordination. 6. It is the government responsibility to establish a universal coverage and equitable basic medical care security system. 7. Some transitional institutional arrangement can promote the effective connection of various medical care security systems. 8. Initial success has achieved in the exploration of MCSS of urban and rural coordination in some areas.Innovation:1. In this study, causes and hazards of the binary structure of China's MCSS in urban and rural areas were analyzed, the opportunity selection to establish MCSS of overall coverage and urban and rural coordination was studied, and the conditions to achieve medical care security of urban and rural coordination in china were demonstrated systematically theoretical analysis, stringent logical argument and empirical research. 2. The basis of the construction of medical care security system of urban and rural coordination. Chongqing is the epitome of China's "big cities" plus "Big Country" and also the pilot area of China's comprehensive reform of urban and rural coordination; it is of important reference value for the exploration and establishment of MCSS in the western China or even the country to sum up their experience in practice and identify the issues and seek the measures. 3. Ways to connect the systems and to narrow the gap between the medical care security systems were proposed based on theoretical research and empirical investigation.4. Construction of the theoretical framework of MCSS of urban and rural coordination under the goal of universal coverage.