Study On The Poverty Alleviation Effect And Restricting Factors Of Medical Assistance For The Poor In Rural Areas

At present,China is advancing the strategy of “precise poverty alleviation” and “healthy China”in depth.The complex situation of poverty and disease interweaving tests the effectiveness of poverty alleviation work of governments at all levels.Because of the heavy expenditure on disease treatment,the poverty level of the rural poverty-stricken people in income-type poverty is deepening,and the multi-level medical security system is urgently needed to alleviate the poverty caused by their medical expenditure.The purpose of this paper is to study the poverty alleviation effect of medical assistance system,the last medical security net,on the rural poor.Taking Liandu District of Lishui City as a sample,this paper calculates the alleviation of medical expenditure of the rural poor after medical assistance intervention,and analyzes the influencing factors of restricting medical assistance to further alleviate the poverty of medical expenditure.Thus,it can provide some decision-making references for alleviating the burden of medical expenditure on the rural poor and realizing the strategic goal of “helping the weak”.Firstly,this paper defines the four core concepts of poverty,catastrophic medical expenditure,total medical self-payment and poverty alleviation effect,and clarifies the logic of this study based on the analysis of the vicious circle theory of poverty,the theory of cooperative governance,the framework theory of sustainable livelihood and relevant research literature at home and abroad.Secondly,on the basis of reviewing the evolution and implementation of the medical aid system in Liandu District,the distribution and characteristics of medical expenditure,catastrophic medical expenditure and the results of poverty alleviation effect before and after the medical aid for the rural poor in the sample area were calculated by selecting poverty alleviation effect indicators.Thirdly,according to the measurement of poverty alleviation effect and related research,the restrictive effect of medical expenditure and medical compensation on poverty alleviation effect of medical aid is analyzed theoretically,and the restrictive effect of individual characteristics and medical treatment behavior on poverty alleviation effect of medical aid is analyzed from the mechanism.Finally,taking the rate of poverty alleviation and the occurrence of catastrophic medical expenditure after medical assistance intervention as dependent variables,a multiple linear regression model and a binary logistic regression model are established.The system of individual characteristics and medical treatment behavior as independent variables to alleviate the burden of medical expenditure of rural poor people is empirically analyzed.Effect.The following conclusions can be drawn:First,after the intervention of medical assistance,the fluctuation of the total medical self-payment fee of the rural poor in the sample area is not intense,and the extent of burden reduction is relatively low.Under the lower proportion of medical assistance compensation,the total medical self-payment rate of more than 70% of the rural poor is between 60% and 80%.Among them,the non-policy medical self-payment fee occupies the main body,to a great extent.This has reduced the quality of life of the rural poor.Second,the disastrous medical expenditure of the rural poor in the sample areas is still serious after the intervention of medical assistance.The incidence of catastrophic medical expenditure was still 43.37%,and it rose to 48.85% through fair adjustment of the concentration index.The average disparity of catastrophic medical expenditure dropped to 22.33% after adjusting the fairness of the centralized index.The relative disparity of catastrophic medical expenditure also shows that the medical burden remains as high as 48.39% of the economic impact on the rural poor.Third,the poverty alleviation capability of medical assistance is still at a low level.The rate of poverty alleviation and the rate of poverty alleviation almost covered by 0~40%.From the disastrous medical expenditure gap,the level of medical aid relief is mostly below 40%.Medical aid only alleviated 8.64% of the catastrophic medical expenses.The average disparity of catastrophic medical expenditure decreased by only 5.85% after medical assistance compensation,and the average disparity of catastrophic medical expenditure remaining before intervention was eliminated by only 21.80%.Fourth,the medical expenditure and the medical compensation from the medical burden alleviation restrict the poverty alleviation effect of medical aid internally.Non-policy medical self-payment fees can not be compensated,reaching the bottom of the medical aid pocket has become an important part of the total medical self-payment fees,and the joint effect of policy medical self-payment fees threatens the alleviation of the medical burden of the rural poor.At the same time,medical insurance reimbursement and medical assistance compensation are at a lower level of actual compensation,which will also restrict the alleviation of the total medical self-payment after medical assistance intervention and the improvement of catastrophic medical expenditure.Fifth,among the individual characteristics,it is more difficult for the rural poor elderly to escape the catastrophic medical expenditure trap after medical assistance intervention than the non-elderly.The poverty alleviation rate of the total self-paid medical expenses of the low-insured households is higher,while the disastrous medical expenditure is more likely to occur in the marginal households of the low-insured.The poverty alleviation rate of the total medical self-payment expenses of the rural household registration poverty-stricken people living in cities is higher,and the probability of catastrophic medical expenditure of the rural poverty-stricken people is relatively greater.Sixth,the types of cancer significantly increase the probability of catastrophic medical expenditure after medical assistance intervention.The poverty alleviation rate of the patients who choose to cross the inpatient and outpatient treatment is significantly lower than that of the patients who choose to go to the inpatient treatment.The frequency of medical treatment has a significant negative impact on the total rate of medical expenses.Based on the above conclusions,this paper finally puts forward some policy suggestions from four aspects: the improvement of technical standards of medical assistance,the establishment of medical aid drug catalogue,the implementation of supplementary assistance for the poor at their own expense,and the efficient cooperation between medical assistance system and other systems.