The Impact Of The New Rural Cooperative Medical System On The Medical Treatment Behavior Of Rural Households

China is a country with a large population,where medical care and health services are significant to national economy and people’s livelihood.The report of the 19 th National Congress of the Communist Party of China established the people-centered development ideology,which will change the situation that the social security system only as a part of economic construction.As an important part of the social security system,the medical security system has always attached great importance to the country and people.The basic medical insurance system in China includes the basic medical insurance for urban employees,the basic medical insurance for urban residents and the new rural cooperative medical system(NCMS),which basically covers all citizens.It has been more than ten years since the implementation of the new rural cooperative medical system.Researchers have conducted many studies on the impact of the new rural cooperative medical system on rural residents.In the past,the literature on NCMS was limited to rural areas,or it was enlarged to urban and rural areas and mixed with other medical insurance systems and commercial insurance.In this paper,all agricultural registered residents are used as research observations,which includes not only rural agricultural registered residents,but also urban agricultural registered residents,which makes the research in this paper more comprehensive.This paper uses the data from the China Health and Nutrition Survey(CHNS)database from 2006 to 2015 and linear regression models and Logit models to study the impact of the NCMS on rural residents’ medical treatment behaviors,and uses the participation rate of NCMS to measure the implementation level of the NCMS.Taking the participation rate of NCMS as a key explanatory variable,compared with the previous literature that directly used individual-level data(someone participates the NCMS or not),which reduces the model’s endogenous problems to some extent and makes the regression results of the model more convincing.The results of the study show that,whether it is a rural agricultural registered resident or an urban agricultural registered resident,the participation rate of NCMS has no significant effect on residents seek medical treatment or not when they are sick.This shows that in terms of whether to seek professional medical services when sick,the impact of NCMS on agricultural registered residents is not statistically significant.In the regressions of whether agricultural registered resident go to the municipal hospital for medical treatment,the results show that for rural agricultural registered residents,the participation rate has a significant negative impact on whether they go to municipal hospital,but for urban agricultural registered residents,there is not enough evidence suggests that the NCMS has a significant impact on whether they go to municipal hospital.With the increase of the participation rate,the probability of rural agricultural registered residents going to municipal hospital is reduced.Due to the characteristics of the new rural cooperative medical system,this may be related to the factors such as the payment starting line and reimbursement ratio,which also shows that the NCMS has positive effect on the hierarchical diagnosis and treatment.The implementation of the NCMS policy achieves the expected effect in this regard,and breaks the prejudice that agricultural registered residents flock to the large hospitals.In the further study part,this paper explores the interaction between the disease degree and the participation rate on the medical treatment of rural residents to the municipal hospital,and the interaction between the chronic disease and the participation rate on the medical treatment of rural residents to the municipal hospital.The regression results show that the impact of the participation rate on the medical treatment of rural residents to the municipal hospital is not affected by the disease degree or chronic disease,which shows that The influence of the NCMS on the choice of medical institutions for rural agricultural registered residents has not been affected by the degree of disease or chronic disease.Whether for patients with mild or severe disease,patients with chronic history or patients without chronic history,the significant influence of the new rural cooperative medical system on the decision-making of the choice of medical institutions for patients exists and has not been affected.The implementation of the NCMS has helped to realize the separation of rural agricultural registered residents in urban hospitals and relieve the pressure of large hospitals.The corresponding urban basic medical insurance system may need to be further improved to promote the hierarchical diagnosis and treatment of urban residents.In addition,according to the results of further research part,the scope and amount of reimbursement for serious and chronic diseases should be further expanded.Although the NCMS makes the rural patients return,the medical technology of large hospitals will be more effective for the serious and chronic diseases which seriously affect the life and health of patients,so we should also effectively guarantee the medical service needs of these patients.