A Study For The Thoery Of Basic Package Of Health Services Design And The Research On Need Analysis Of The Residents’Medical Insurance Design

CPC Central Committee identified the right of everyone to the enjoyment of basichealth services as one of the important goal of building a moderately prosperous society,ordered to construct three basic medical and health system to cover urban and ruralresidents, including basic medical insurance system for urban residents. The aim of thisdissertation is to explore thoery and method for―basic health services package " neededby urban residents, analyze the knowledge on URBMI, willingness to pay and ability topay of urban residents, to propose the recommendations to design a health serviceinsurance package to meet China’s national conditions for urban residentss, to provide abasis for our country to establish and improve the integration of urban and rural areas,prevention, medical, health care health care system.The most important issue for basic health services package design is how to improvethe efficiency of health services, to analyze the costs and available resources is needed, and then adjust the content contained, up to and including the elements of the project andthe level of resources available to reach a balance. The cost-effectiveness analysis ismethod to get the most efficient use for limited resources, to analyz of the method ofevaluation of health programs use resources and access to health benefits. By usingcost-effectiveness analysis, decision-makers could choose from these items. Although thecost-effectiveness analysis could not tell us society should be engaged in which healthservice, but it provides a framework of the effectiveness and efficiency of the healthservices. Once you have these results, consumers and health policy makers could make asensible, scientific decision on the adoption of what kind of projects. However, in thedesign of health services package, should take full account of social factors such as socialinstitutions, public preferences.The study used the household survey method. Based on the national statistical system,Xi’an, Baoji City, Guangzhou and Zhuhai UHS household survey samples wererepresentative and questionnaire was reliability.350,150,447and150questionnaires havebeen collected repectively.The suvery showed: Four cities were25.21%,30.67%,45.94%and40%ofhousehold health expenditure rate exceeds its capacity, the four cities at this stage ofmedical expenses weak, a heavier burden on health spending. Xi’an51.7%of thepopulation can withstand current payment levels,41.1%of the population can withstandlife. Baoji and Guangzhou residents can withstand more than60%of life, about20%ofthe residents be able to withstand the current level of payment. Zhuhai55.3%of thepopulation can withstand life,32.7%of the population can withstand the current level ofpayment. Xi’an and Baoji, about90%of the surveyed households purchase workers’insurance, commercial insurance purchased by30.9%and26.7%of households; greatlyreduce the proportion of surveyed households in Guangzhou and Zhuhai purchaseemployee insurance.The majority of households of four cities worried about the cost of medical treatmentfor the low reimbursement ratio, and secondly, they worried about the complexbureaucratic procedures for reimbursement. Xi’an, Baoji and Zhuhai, most of the people thought that the medical costs attributable to a reasonable proportion of the householdincome of1%-10%, followed by10%-20%; most of the residents of Guangzhouresidents that the medical costs attributable to a reasonable proportion of the householdincome5%-10%, followed by20%-30%. Most of the residents of the four cities thatMedicare payment attributable to a reasonable proportion of the household income is1%-5%, and secondly, Xi’an, Baoji and Guangzhou that the proportion of Medicare paymentshould be less than1%, Zhuhai should be5%-10%. There is still a significant proportionof residents should be10%-20%or higher. Most of the inhabitants of the four cities thatindividual contributions accounted for30%or less, more than half of the residents of thatindividual contributions accounted for10%, Xi’an and Baoji proportion of individualsshould a high proportion of10%of the population in Guangzhou and Zhuhai, Guangzhouand Zhuhai individuals accounted for10%-30%of the residents is higher than in Xi’anand Baoji.The three most want to include in Baoji, Guangzhou and Zhuhai were emergencyservice, to buy medicine in durgstore and outpatient dispensary, the most want to includein Xi’an were to buy in durgstore, emergency service and out-patient services. The fourCities residents, mainly in common disease and illness, prevention, care and emergencybut a lower proportion of residents in Medicare should be targeted at the major. The vastmajority of residents believe should be increased oral outpatient treatment, hospitalizationfollowed by oral health and oral. Among them, the residents of Xi’an and Baoji residentsin Medicare should first increase in oral outpatient programs fillings and dental,Guangzhou and Zhuhai residents believe that the oral examination. Xi’an and Baojihouseholds main concern of residents in Medicare reform is to simplify reimbursementprocedures, followed by the lower co-payment ratio, Guangzhou and Zhuhai pay moreattention to reduce the proportion of co-payment, followed by lower pay line.To meet the needs of the urban residents better for URBMI, it is necessary to adopt acost-effectiveness analysis, a more rational design of the package of health services,effective use of health resources. Moreover, we should enhance propaganda in urbenresidents, and improve residents’ knowledge and understanding of the health insurance. Simplify the use of URBMI reimbursement procedures, improve residents healthinsurance convenience. Increase the diverse financing levels, meet different people‘s needrational allocation of medical resources, improve the level of community health services.Therefore, perfact medical insurance for urban residents, and to create the conditions forthe Medicare system of universal coverage.