Nvestigation And Analysis On The Status And Satisfaction Of Cooperative Medical Service In New Agricultural And Pastoral Areas In Yili

Objective: To understand the operation status and existing problems of 2009-2016 years' cooperative medical system in new agricultural and pastoral areas of Yili,and summarize the experience of rational evaluation and management of cooperative medical system in new agricultural and pastoral areas.In this area,the factors affecting the satisfaction of the participants in the nncms were discussed.It can not only summarize the experience and propose suggestions to the NCMS,but also provide reference and reference for the smooth development of the basic medical insurance system for urban and rural residents in the future.Methods:(1)the current situation of NCMS was described by using 13 new NNMS operation indexes.(2)the purpose of sampling 5 representative NCMS managers is to conduct in-depth interviews.(3)field survey was conducted on the satisfaction of 320 NCMS participants in two villages in Yili.The data were analyzed by SPSS17.0software.The mean value was used for statistical description.The Logistic regression was used to analyze the related factors influencing the total satisfaction of NCMS.Results: the current situation description:(1)the rate of participation in 2009-2016 years remained above 95%,The rate of participation in 2012-2016 years remained above 99.3%.,The average growth rate was 0.57%higher than that of 0.34%in Xinjiang;(2)in 2016,the average number of participants was 11 thousand and 300,higher than the 9 thousand and 500 in Xinjiang;(3)the proportion of central subsidy,autonomous region subsidy,local subsidy and individual payment in 2009 was 30.08%,30.62%,16.71%and 22.54%,The proportion of 2016 turned into 52.54%,14.63%,7.14%,25.25%,The raising of capital per capita has been increasing gradually year by year,reaching 570 yuan,The average growth rate of 33.65%was higher than that of 30.94%in Xinjiang;(4)and the overall benefit increased from 87.9%to 273.22%in the year of 2009-2016 years,The average rate of hospitalization increased from 42%to 64.08%in the year;(5)the use rate of the fund in 2011 was 82%lower than 84.21%in Xinjiang,lower than the standard of 85%;In 2013,the utilization rate of the fund was 107.3%higher than that of 103.04%in Xinjiang;Through in-depth interviews with managers are:(1)state and county personnel are of the view that the development of new rural cooperative medical system overall is very good;(2)state managers think the problem occurred mainly in the large medical institutions supervision,The staff at the county level believe that in the process of handling,the staff are under pressure and the managers are scarce,There is a lack of long-term mechanism control in personal payment;(3)the management staff of a township health hospital and the village doctors in a township health hospital all think that the staffing of medical and health technicians is lacking,The satisfaction questionnaire survey can be obtained:(1)the satisfaction rate of the total satisfaction of the participants is 100%,The total proportion of total satisfaction in the total satisfaction of the participants was 83.75%,and the proportion of the total satisfaction was 16.25%;(2)among the 14 new CMS satisfaction items,only the average degree of satisfaction of the large disease reimbursement range was less than 75,The remaining 13 new CMS satisfaction items were more than 75 points;(3)in the Logistic two yuan optimal regression equation,gender,medical insurance cost,reimbursement rate of serious illness,outpatient reimbursement for chronic diseases,reimbursement of hospitals in three hospitals,reimbursement for reimbursement and reimbursement process in village health clinics are all protective factors.Conclusion: Yili new rural cooperative medical system is a kind of low level,wide coverage of the medical security system of mutual aid,the central government has become the key of sustainable development;the remarkable achievements,social evaluation is higher;agency personnel shortage,the handling capacity needs to be improved;to pay health insurance costs,reimbursement ratio,chronic disease outpatient reimbursement,hospitals and outside the village health clinic reimbursement,reimbursement,reimbursement process has become a key factor to control the overall satisfaction.