Study On Urban Preschool Children Health Insurance In China

Objective: In this paper, theoretical research on domestic and international health insurance based on the use of health services in the Fourth Survey and the statistical data of health of urban pre-school children to understand the basic health and medical insurance status and the level of the economy made by selecting three cities Typical areas of research, analyzes the status of pre-school enrollment, utilization of medical services and medical insurance coverage throughout, overall level, the level of funding, payment and other issues, pre-school children to participate in health insurance affecting factor analysis did not participate in Children's Health Insurance deep-seated reasons for the further improve children's health insurance system in China provide a realistic basis and policy recommendations.Methods: This systematic search of medical insurance for children of relevant literature and related health insurance policies, through analysis and treatment for research reference. This study used quantitative and qualitative research method of combining quantitative research method is to survey, according to China's social economic development level, in the eastern, central and west of the extraction of Suzhou, Wuhan and Guiyang City for the survey area, Randomly selected for each survey area four community health centers, community health centers from each register of child care by age 0-5 years old children randomly selected from 50, make an appointment by telephone questionnaire survey site, the actual collection of 542 valid questionnaires . Questionnaire to obtain information, including demographic situation, health services demand, utilization, insurance and medical insurance benefits case, the family financial burden; the same time through the center of Wuhan City, the computer system to obtain health insurance riverbank area in 2009 were the number of hospitalized children aged 0-5, Hospitalization costs and the amount of compensation and other data for analysis. Qualitative research mainly through semi-structured questionnaire on the health insurance sector, health administration, key informant interviews with community health organizations to obtain insurance situation of the local children, the use of health care costs, policy development and implementation, and to improve and perfect Existing systems or develop new policy recommendations. Results: (1)Establish the reality of children's health care system needs, including children, demand for health services, health care costs; urban children's medical security system imperfections; major diseases threatening the lives and health of children; building a harmonious society will inevitably requires the establishment of universal health care system four aspects. (2) The health care of children are medical insurance for urban residents, the new rural cooperative medical care, hospitalization of children around the catastrophic health care insurance and medical assistance. (3) To compare Suzhou, Guiyang, Wuhan City, the three children in health insurance policies, are to improve children's health insurance funding criteria, and improve the government's subsidy standards, given the cap on the continuous line of insurance and reimbursement of the incentives. Suzhou City get through the insurance fund between the channel; Guiyang City, the establishment of "treatment waiting period" to encourage infants to participate in health insurance as soon as possible. (4) Basic analysis of survey samples, 542 valid samples were investigated, of which male to female ratio was 1.23:1,70% of the children mainly by parental care; mother education level mainly in the intermediate and advanced levels; three the highest average annual family income of Suzhou, Wuhan minimum; 56.8% of children participate in at least a health insurance and another 43.2% of children do not participate in any health insurance; child's parents do not understand the policies related to children without medical insurance The main reason insurance; insured children had 47.08% of the children participated in medical insurance for urban residents, 24.35% of the children in the new rural cooperative medical care, 25.97% of the children in commercial insurance; parents of current satisfaction with child health insurance policy is only 30 %, the main reason for dissatisfaction is less reimbursement program, reimbursement levels are low. (5) Analysis of child health care utilization and costs, analysis of the prevalence of children in two weeks, 97.2% of the sick children were treated, mainly due to the parents due to illness did not seek medical treatment that mild; 63.6% of children in city hospitals treatment; outpatient concentrated in the range of 100-1000 yuan. Analysis of the situation of children hospitalized, 96.4% of children hospitalized due to illness had to be hospitalized, 80% of children are without referral to hospital directly to the parent's; Suzhou City, the average cost of hospitalization of children the highest, reaching 5253.5 yuan, Guiyang City a minimum of 3,592 yuan; children hospitalized with pneumonia and the number of days are the highest cost of treatment. (6) Analysis of 2009 Jiang'an District, Wuhan Children's Hospital medical expenses and reimbursement of expenses, hospitalization costs 2673.42 yuan per capita, the amount of compensation per patient was 663.41 yuan.Conclusion: Gender has little effect insurance for children; compared to the population of foreign workers and non-resident, resident population of the city but pay little attention to children's insurance; the mother's educational level affect the insurance rate for children; with family income Increase the incidence of the insured the rapid rise in the average total monthly household income levels regression coefficient is negative, the more good economic conditions, the less inclined to insured families.Suggestion: (1) The Government actively guide children to participate in medical insurance.(2) Encourage the establishment of children's insurance policy.(3) Designated organizations to expand health insurance. (4) The flow of children to participate in Medicare establish smooth channelsInnovation and limitation: The innovation: (1) Using binary logistic regression analysis of factors affecting children to have health insurance; (2) Children's health insurance policies now do comparative analysis. Limitations of this study: the integrity of the information is not, only collect data on hospital reimbursement Jiang'an District of Wuhan, which is the comparison of data between different parts of caused some obstacles.