| With the development of economy and society, the desease pattern of the rural residents has made a great transformation, and the chonic disease has gradually become the major diseases effecting the rural residents'health, simultaneously, it brings huge economic burden to society, family and individual. In 2008, there are 210 million diagnostic chronic patients in our country, therefore, it takes an increase of more than 50 million since 2003. The economic burden of the chronic patients is aggravating gradually, in 2003, the burden made by hypertension, diabetes, coronary heart disease, cerebravascular disease and tumour is 120.95 billion, which accounted for 18.37% of the national health accounts and 21.05% of the national medical accounts. According to the data, of China National Health Services Survey, the prevalence rate of rural chronic diseases is 120.5%o in 2003, and till 2008, the rate had been up to 139.9%o. Chronic diseases have been affecting seriously people's health and life all over the world. Global action to prevent chronic diseases could save the lives of 36 million people who would otherwise be dead by 2015 says the World Health Organization (WHO) report, Preventing Chronic Diseases:a vital investment. Approximately 17 million people die prematurely each year as a result of the global epidemic of chronic diseases.Many study projects about chronic diseases have been done, but most of those studies were about prevalence of chronic diseases originally. These years, some researchers began to research the economic burden of chronic diseases, but hardly about the rural chronic patients and their families, especially the effective control measures of their economic burden. Financed by European Union, the thesis did some deep research on the economic burden of rural chronic diseases, and discuss the further measures on how to reimburse the rural chronic patients and their families through NCMS. This study aims to answer the following questions:(1) How does NCMS reimburment the rural chronic patients at present; (2) How are the effects of the reimburment; (3) The necessity and feasibility of the reimburment.the major objectives of the thesis are as following:(1) Analyse the economic burden of rural chronic families and the ensurement measures of them to further define the economic burden and risks of the rural chronic families; (2) Analyse the controlling condition and effect of NCMS to the rural chronic families, and make strong policy basis on perfecting NCMS and controlling the risks.In this study, stratified sampling is used to select samples in Shandong Province and Ningxia Hui Municipality in 2006 and 2008. According to the development levels of society and economic and the geographical distribution, Zhangqiu City (high economic level), Changle County (middle economic level), and DongE County (low economic level) in Shandong provice; and Qingtongxia (high economic level), Yongning County (middle economic level), and Zhongning County (low economic level) in Ningxia Hui Municipality are selected. The corresponding townships and villages are also selected by the same method. The sample size of Shandong Province is 3335 families in 2006 and 1635 families in 2008; The sample size of Ningxia Hui Municipality is 2802 families in 2006 and 1652 families in 2008.the major foudings of the thesis are as following:(1) The economic risks of the rural chronic patients was much more serious than the average level. Though prevalence rate of the rural chronic patients decreased a little, it was still higher than the average national level, and the annual hospitalization rate was far higher than that of the fourth China National Health Services Survey. Furthermore, more than 50%of the rural chronic patients did not take hospitalization for the reason of financial difficulties; (2) The rural chronic families are also confronted with ponderous economic burden, and most of the families did not have the abilities of defending the economic risks, and the lower the income was, the higher economic risks they got. (3) According to the harm of the chonic diseases and the operating condition of NCMS, the thesis suggests that it is necessary and feasible to further take the cost of chonic diseases into NCMS funding management, but it should be adapted to local conditions and step by step.We got several conclusions after analysis as following:The economic risks of the rural chronic patients and their families has been very serious, and most of the families did not have the abilities of defending the economic risks. As the only health insurance of the rural residents, NCMS should strengthen the medical insurance of the chronic patients especially their families, and improve the the financing equity of the health insurance. Furthermore, NCMS should link up with the medical assistance scheme to provide comprehensive effect with limit resources on rural chronic patients, and ensure that they can get timely treatment and relief their disease economic risks.
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