A Study On Residents' Satisfaction For The Chinese New Medical Reform Policy And Analysis Of Related Enfluential Factors In Zhejiang Province.

Objective To investigate residents'satisfaction for the current status of medical services and the medical reform policy,so as to provide better and more convenient medical care assurance systems.Method 1581 objects and their families were enrolled into this questionnaire by a stratified cluster sampling method from 32 counties of Zhejiang province,including Wenzhou,Hangzhou,Ningbo,Lishui,Taizhou,Quzhou,Shaoxing,Huzhou and other regions. This questionnaire covered 108 medical and health institutions at various levels,incuding public hospitals, urban and rural health centers,health stations, community medical service centers and service stations, etc. The study team sent out questionnaires, and interviewed people,then recorded the results in different areas respectively. They explained the purpose and some projects of the questionnaire, then collected questionnaires on the spot. A total of 1600 questionnaires were issued and 1581 were collected, among which 1577 were valid. The recovery and effective rate was 98.8% and 98.6% respectively. In this investigation, all the investigators personally went to every place to know the actual local medical conditions, and made a face to face interview in person with the informants to finish questionnaire according to their standard-designed questionnaire. The data was designed and input by the software of Excel 2003, then analyzed by the SAS9.2 software. The relationship between residents' satisfaction to hospitalizing and the health reform with different factors in Zhejiang province was tested by ANOVA andχ2 test.Result (1) Social demographic characteristics of objects of the study: the majority of profession were workers and peasants, accounted for 44.20% in 1577; registered permanent residence was mostly in village, accounted for 52.77%. There were 687 cases(42%) in expenditure patterns of one's own expenses.(2) Influence to the local's satisfaction to the chinese medical reform:in 1577 cases, there were about 79.38% of people supporting the new reform policy definitely, and about 50% of respondents thought that a new reform can relieve the phenomenon of difficult and expensive to see a doctor, about 50% of people think that it didn't wok effectively, even made it more prominent.(3) Hospital choice and satisfaction to the new medical reform: more men believed that it becames more difficult to see a doctor. In different professional groups, civil servants payed more attention to new medical reform. Most civil servants supported this policy. Designated hospital to apply for reimbursement was the first choice to the institution workers. When they were uncomfortable, the majority of civil servants choosed a big hospital, the majority of institution staff in the majority choosed to buy medicine in drug store. To farmers and workers, they took no steps only when they can't stand it.Convenient transportation or near home became the principal element to choose hospital for workers and farmers. In different group subjects, highly educated people were more likely to choose a big hospital or designated hospital. Low academic people preferred to community hospital or private clinic. In different family year income groups, the ratio that high-income family choose a big hospital was greater than that of low-income families. When they were not comfortable, low-income families, at one's own expenses, non-commercial insurance, medical insurance of town and farming people were willing to choose a community health service center or private clinic or to buy medicines from drug store or to take steps when they can't stand the diseases.(4) Resident satisfaction and the change of medical charging standards since the implementation of medical reform: In check, medical fee, test, bed, operation and drug prices, most people thought it was higher, which workers and farmers had the most strong reaction. In different degree and family year income level, in the above charging standards, the higher of the degree and family year income, the lower of the ratio in high fees. The ratio who were at one's own expenses, non-commercial medical insurance, no medical insurance of town or farming people thought it charged too much was lower than that of reference group proportion, especially the group at public expense was apparent. In village, town and city the ratio of the above fee standards charging too high dropped in accordance with the sequence.Conclusion(1) The majority of respondents supported new reform policy, nearly half of respondents thought the new reform policy reduced the difficulty to see a doctor, and nearly half of people think it did't work out effectively, even made the condition more prominent. This suggested that the new reform policy should be perfected to solve the expensive and difficult problems to see a doctor effectively.(2) There were differences in hospital choose and medical satisfaction in research objects on the basis of gender, age, occupation, education, family year income, medical spending form and registered permanent residence. Much more residents think it was more prominant to see a doctor expensively and difficultly. People with highly education, high family income and public expense were more willing to choose a big hospital or designated hospital to submit an expense account. People with one's own expense, non-commercial medical insurance, no medical insurance of town, farming, low degree and a low family year income group preferred to community hospital or private clinic. This suggested our government should intensify efforts to solve the problems of rural health care, expand community hospital size, number, and improve the technical level and the quality of service in rural and urban regions.(3) Residents of different gender, age, occupation, education, family income and medical expenses, registered permanent residence had different satisfaction to the change of medical charging standards since the implementation of medical reform. Most people thought the medical care and drug price was higher, which workers and farmers had the most strong reaction. Highly educated and family year income groups drop the ratio who think that the above fee standards is higher. The ratio who were at one's own expenses, non-commercial medical insurance, no medical insurance of town or farming people thought it charged too much was lower than the contrast group. In village, town and city, the ratio of the above fee standards charging too high dropped in accordance with the sequence. This suggested the government should increase the financce, drop the drug prices in rural and urban drug-store using multi-channel and reduce the treatment cost of community hospitals.