The Study On Operation Of New Rural Cooperative Medical System In Three Counties Anning, Jinning, Songming, Kunming City

Objective By surving the New Rural Cooperative Medical System(abbr NRCMS)in three counties of Kunmin City,comprehensively understand the operation of NRCMS in three counties,comprehensively evaluate the success and inadequacies when operating NRCMS,put forward countermeasures and suggestions,provide a reference for further improve NRCMS.Methods This study is epidemiological descriptive cross-sectional study.Using report form and questionnaires,collect such information as compensation plan,participation,fund-raising case,use of funds of three counties since 2006;use multi-stage sampling method to sample three-county party and government cadres,NRCMS managers,doctors and participating farmers, survey their comments and suggestions on NRCMS.Results Farmer's satisfaction degree toword current NRCMS is more than 80%,toword counties and townships NRCMS management office(abbr NMO) is more than 70%.In 2008, participation rate in three counties is over 90%,and three counties are all up to 90 yuan per capita financing standards.In 2006,2007 and 2008,hospitalization compensation benefit rate of Songming County were 4.44%,4.42%,6.22%,of Jinning County were 6.21%,7.98%,9.02%,of Anning City were 5.48%,5.86%,6.51%.In 2008,utilization rate of funds of Anning City were 90.56%,79.98%of Songrning County,65.88%of Jinning County.Out-patient benefit rate of Jinning County is 96.43%,Anning City for 45.75%,29.91%of Songming County. Compensation for the county hospital three views on the county and township levels of medical institutions,at the county level than at the township level,the amount of reimbursement of medical institutions on the county level.Actual hospitalization compensation ratio and average compensation is lower at all levels of hospitalParty and government cadres and managers two think reason for fund precipitation includes lower compensation ratio,higher hospitalization compensation pay-line,medication restrictions (P = 0.527).Farmers feel after participation household enjoying the five guarantees and All poor households and economically disadvantaged families do not have the ability to see a doctor(P = 0.11),more than 20%of the Senate combined the two farmers that have no ability to see a doctor.Farmers,managemers and more than 20%doctors and party and government cadres that "the rich help the poor" phenomenon.Farmers,party cadres and managemers most support rural cadres door-to-door to charge the cost to participate in NRCMS,87.2%farmers want to maintain the same reference standard 10 yuan, hope to improve the accounting for 10.4%,to reduce the reference standard very few(2.5%). And the latter two tend to increase the participation of medical staff standard.All farmers were inclined to support the Senate co-ordinate out-patient(excess family account of 11.3 percentage points).Farmers want to raise the compensation ratio(hope the maximum compensation ratio of 70%),party and government cadres and doctors as well as more than 30%managers support increasing the compensation ratio.Conclusions Three counties to maintain a high level of participation in 2006,2007 and 2008. Funding is in good condition.Three counties have been increasing in each of the utilization rate of funds,but funds still exist to some extent the phenomenon of precipitation.Three counties to benefit from the rate of hospitalization of compensation increase over the years.Out-patient benefit from the rate reduction year-on-year increase,but the level was still low.Compensation at all levels,the proportion of hospital and meeting the actual compensation costs are lower, more conservative cost control.Advocacy to mobilize the proposals to improve the farmers of the new awareness of the IICA.Gradual improvement of government-funded multi-based long-term financing mechanism.Starting to develop a reasonable pay line,cap line and the compensation ratio of the standard,and gradually establish a perfect "hospital out-patient co-ordinate co-ordinate +" compensation program,compensation program to give financial difficulties of preferential policies to improve the fairness of the new IICA.Strengthen the supervision of medical institutions to control the growth of medical expenses.Strengthen the rural health service network,and strengthening the township and village levels,the construction of health institutions.Sound fund management system,strengthen the operation and management of construction funds.To increase funding support to improve the management level of the new IICA,IICA strengthen capacity-building managers.