Research On The Model Of Health Examination In The New Cooperative Medical System

Objective According to the analysis on connotation, stakeholders and problems of health examination in the New Cooperative Medical System(NCMS) and comparison of designing,effection, advantages and disadvantages among different models of health examination,the thesis discusses the appropriate models of health examination under different objectives,and raises reasonable countermeasures and proposals,which can promote health examination in the NCMS smoothly.Methods Through theoretical analysis, field survey and interview,the connotation, stakeholders,problems and appropriate models under different objectives were analyzed by applying theories and methods of public management,health management,health economics,biostatistics and so on. The main methods include literature study, field survey, interview, questionnaire survey and biostatistics.Results1) Health examination in NCMS is provided for the farmers who have been in the NCMS for a period of time.It is under the unified leadership of government,and requests the health sectors to take the lead in collaboration with other related departments. Township hospitals are the main implementing agencies.2) Objectives of health examination in NCMS:①In the beginning of NCMS,the main objective is to expand the compensation benefit of farmers joining in NCMS and ease pressure on the fund balances;②In-depth development of NCMS,the main objectivs is to manage farmers'health by disease prevention and health education.3)Main contents of health examination in NCMS:①The designing of health examination;②Channel and payment of funds;③Methods of paying funds;④Defining the farmers of health examination;⑤Setting the items and contents of health examination;⑥Standards of township hospitals and doctors;⑦Arrangements of time,place and organization;⑧ Stakeholders'role in health examination;⑨Monitoring and using.4) Typical models of health examination in NCMS:①A:Limited range of farmers and menu-set items;②B: Funds from Public health expenditure and different standards;③C:Wide coverage and simple examination;④D:Two-step and targeted examination.5) Main problems of health examination in the NCMS:①Different concept of designing;②Funds of health examination from NCMS is questionable;③Methods of determining physical objects is questionable;④Contradictions among items,funds and farmers'expectations;⑤The use of funds is low efficiency in somg areas;⑥Service capacity of some towns hospitals is limited;⑦Policy advocacy and health awareness among farmers should be further strengthened;⑧Different standards is not conducive to control the quality;⑨The use of health examination is not enough.Conclusion1)Clear the duties,rights,and benefit among government, institutions and farmers;2) According to different objectives,appropriate models of health examination must meet with local conditions and the development of NCMS;3) The current policy of health examination in the NCMS should keep its stability and continuity for a certain period of time and be defined by law;4) For the further development,health examination in the NCMS should be integrated with other health examination in rural areas and put into the range of Public Health, in which government plays a dominant role;5)The uniform standards of health eaamination must be established to control guality;6)Healthy information should be collected, collated and used timely by building and applying the network and information technology;7) The organizations and monitoring system of health examination must be established and improved;8)Promte the quality of health examination by strengthening capacity-building and doctors'ability of township hospital. In this process,county-level medical institutions play a guiding role.