Research On The NCMS Program Adjustments Impact On The Seeking Behavior Changes Of Haiyuan County’s Rural Residents

Objective Through the combination of the implementation on the NCMS programadjustments(implemented reimbursement to outpatients and patients of participating farmersand the reimbursement was adopted as stepped differentiation) in Haiyuan County, NingxiaHui Autonomous Region,to know the seeking behavior of rural residents before and afer theNCMS program adjustments (2009-2012),analyze its influencing factors, comprehensivecomparise the changes its seeking behavior and factors in the past few years,explore its causeschangeresearch whether the NCMS program adjustments health services for rural residentsreally use to produce favorable results,Thus providing a theoretical basis for promoting thetransformation of Ningxia farmers seeking behavior, and promote the sustainabledevelopment of new agricultural cooperation and improving the health of rural residents, andprovide the appropriate policy basis for the realization of the overall goal of health carereform.Methods This study used a quantitative research methods.Implementing ruralhousehold survey to farmers in Haiyuan County of Ningxia Hui Autonomous Region throughTwo-stage stratified random sampling method in2009as a baseline data and follow-upsurvey conducted in2011,2012.Using univariate analysis for. General demographiccharacteristics, medical patient flow, and other indicators of health care utilization of HaiyuanCounty rural residents.Adopting multi-Logistic regression model and gray relational analysisfor influencing factors of seeking behaviors.The using the analysis software were SPSS18.0and Grey Modeling.Results （1）Among the Sociological characteristics of the surveypopulation,age group, marital status, education level between three years and has astatistically significant difference, there is no significant difference between gender and nationality;In the conditions and means of survey treatment, the new rural cooperativemedical insurance rates increased year by year, raise the level of perceived health, distance tothe nearest medical institutions at all levels basically unchanged（.2）Week prevalence rate wasdeclined from17.1%in2009to11.8%in2012, the difference was statistically significantafter standardized; two weeks of untreatment in2009was61.1%, and down to54.8%in2012,the difference was statistically meaning; survey the2009year of hospitalization was7.8%,6.9%in2011, and6.7%in2012; hospitalization rate decreased year by year, the differencewas not statistically significant（p=0.596）.（3）The top three selected outpatients institutionsof surveyed objects in2009were county hospitals (30.4%), township hospitals (24.8%),village health (19.7%),2011and2012Survey choose county hospitals and outpatient declinein the proportion of township hospitals, village clinics choose the proportion rises to2012thetop three are village health (47.5%), township hospitals (21.9%), county hospitals (19.9%),between the three institutions Survey clinic flow significantly; between the three institutionsSurvey choose county hospital inpatient always came first, the proportion accounted for morethan53%to township hospitals hospitalized declining proportion of proportion to or abovethe county hospital increased year by year.（4）The Logistic regression analysis of Treatmentagencies Survey objects showed that the factors were investigation years and geographicaccessibility; Gray correlation analysis of the top five factors affecting the intensity ofoutpatient institutions were national ranking, age, survey year, marital status, sex; The top fivefactors of inpatient treatment institutions affecting the intensity of pre-qualifying areself-perceived health, the survey year, marital status, distance to the nearest townshiphospitals, and nation.Conclusion After the NCMS program adjustments implementation,Haiyuan County seeking behavior of rural residents undergone great changes, better achievethe desired effect, the specific findings include:(1) two-week prevalence rate was declinedyear by year, health of rural residents was improved;(2) the proportion of rural residents tosee a doctor after the illness improved, but pure high proportion of self-medication, two weeks prevalence and hospitalization rates decreased within a year, and not because offinancial difficulties treatment of the phenomenon can be improved;(3) evaluation of the ruralresidents of village clinics and township hospitals have been greatly improved, but the countyhospital evaluation changed little;(4) After selecting the prevalence of rural residents abovethe county level and a significant decline in the proportion of hospital, choose the proportionof township hospitals remained unchanged, and the choice of the proportion of village healthincreased from19.7%to47.8%before the reform.