Studies On Farm Households' Economic Behavior Under The Risk Of Major Illness In Poverty-Stricken Areas

During current social and economic transition, as the basic unit, farm households are confronted directly with the economic, social and natural risks, among which, the impact of illness risk is the most serious and profound. In recent years, the illness risks confronted by farm households have been becoming more complicated and various for the acceleration of rural labor migration, the change of diet and living habit, as well as the aggravation of environment pollution and population aging. On the other hand, in the lack of rural medical care system, medical expenditure of farm households is increasing, and illness, especially the risk of major illness, makes them hardly to cope with just by their own resources. In rural areas, particularly in poverty-stricken areas, health-related poverty is still serious. Faced with the risk of major illness, farm households have formed a series of economic behavior through making use of their own and external economic resources available and adopting every possible approach to achieve the maximum of household economic interests.Based on theories and researching approaches of agricultural economics and management, sociology, health economics and development economics, the dissertation studies economic behavior of farm households in poverty-stricken areas under the risk of major illness by using large sample sized survey data and abundant case studies and intensive interviews. It aims at finding out farm households' needs for medical care through analyzing their behavior and motivation when coping with major illness, according to which the dissertation puts forward corresponding suggestion for medical service and government policy making, in order to improve rural medical care system and help farm households to get rid of poverty and illness.The dissertation consists of seven chapters. Chapter 1: Introduction, which puts forward issues, objectives and contents of the dissertation, as well as the researching approach, data information, framework and innovation and weakness. Chapter 2: Theoretical basis and literature review, which defines key concept used in the dissertation, expounds the theoretical basis and then conducting literature review on the risk of illness and farm households' behavior on which it points out the direction and significance of this research. Chapter 3: Analysis on major illness of farm households in poverty-stricken areas. First of all, it finds out illness occurrence in poverty-stricken areas on the whole with individual as the object using large sample sized survey data of farm households and Probit model. And then it analyzes the occurrence of major illness to farm households in poverty-stricken areas by negative binomial regression model regarding farm households as the object. With indexes of farm households' livelihood capitals established, it compares the differences of livelihood capitals of farm households with major illness and those without to find out the impact of major illness on farm households' livelihood. With analysis on representative cases, it further recognizes the impact of major illness on the economy and supply of labor force of farm households. Chapter 4: Analysis of the treatment-seeking behavior of farm households under the risk of major illness. Based on the theoretical analysis of farm households' treatment-seeking behavior, it studies their actual behavior from perspectives of regions, gender, age and household economic situation and finds out factors influencing their treatment-seeking decision and expenditure by Heckman Two-Stage model. Chapter 5: Survey on financing behavior of farm households under the risk of major illness. The importance of financing for farm households with major illness is demonstrated through comparing the financing process and effect of two farm households with major illness. It classifies the financing behavior of farm households under the risk of major illness into two categories according to different sources, which are internal financing and external financing, and makes a detailed description of these two kinds. And then it explores the selection of internal financing behavior and the constraining factors of the external financing behavior. Chapter 6: Study on labor force supply behavior of farm households under the risk of major illness. On the basis of the theory of labor force supply, it analyzes the change of labor force supply with a focus on the adjustment of gender and age, then that out of the household emphasizing the quantity change under the risk of major illness. Chapter 7: Conclusion, which summarizes the findings through the research and puts forward certain suggestions for enhancing farm households' ability to resist major illness and improving rural medical care system.The findings in the dissertation are as follows. Firstly, the occurrence of major illness to farm households in poverty-stricken areas is rather serious, which is affected by household population and economic situation, health recognition, health service available and the existence of New Rural Cooperative Medical System. Secondly, major illness exerts a remarkable impact on the livelihood capitals and strategies of farm households in poverty-stricken areas. Further, it obviously affects farm households' financial capital, as well as human capital and physical capital, while hardly affects their social capital. Thirdly, the treatment-seeking behavior of farm households with major illness presents several characteristics that the treatment-seeking rate of the female is higher while the treatment expenditure is lower than that of the male and that the treatment-seeking rate and expenditure of poverty-stricken farm households is lower than the rich and so on. Fourthly, when coping with major illness, farm households make a wide use of internal financing and depend heavily on such behavior with a limited use of external financing. The selection of internal financing is greatly varied because of different resources endowment of farm households while the external behavior is constrained by a series of institutional factors. Fifthly, the initial equilibrium of time allocation among agricultural production, non-agricultural work and housework of farm households suffering from major illness is changed. Therefore, they have to adjust their labor force supply such as the adjustment of gender, age and quantity change of labor force supply out of household, to maintain living.Based on the large sample sized survey data of farm households and abundant cases, the research discusses economic behavior of farm households in poverty-stricken areas under the risk of major illness through quantitative and qualitative analysis. The innovation of this dissertation is represented in following aspects.The first innovation regards the selection of the research topic. With the farm households in poverty-stricken areas as the object, the dissertation studies the economic behavior of those with major illness under the background of social and economic development and transition. It not only enriches current theoretical system on farm households behavior which is studied from the perspectives of production, consumption, investment and adoption of technology, but also provides evidence for further recognizing treatment behavior of farm households with major illness in poverty-stricken areas, enhancing their ability to cope with it and improving rural medical care system.With regard to the data utlization, the dissertation uses survey data of 6003 farm households and intensive interviews with 303 ones. Abundant researching variables included, the data is the latest one on farm households with major illness in poverty-stricken area. The dissertation deeply explores the risk of major illness and economic behavior of farm households from new perspectives for the adoption of variables of farm households' livelihood capital and the division of major illness. Further, large sample sized survey data of farm households supports the empirical analysis and conclusion in the research, together with the intensive interviews and folk language showing vividly the behavior of farm households under the risk of major illness.Concerning the research approaches and means used in the dissertation, it is standardized and advanced. Using large sample sized survey data of farm households, the dissertation makes use of Probit Model to analyze illness occurrence in the sample and the influencing factors, as well as negative binomial regression model for illness occurrence of farm households and the influencing factors and Heckman Model for treatment-seeking behavior of farm households with major illness. In addition, individual oral narration and case studies well supports the conclusion educed from quantitative analysis and make readers deeply perceive farm households' demand for medical care.