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Jiangxi NCMS pilot areas fairness elderly health services research

Author: YangQing
Tutor: YuanZhaoKang
School: Nanchang University
Course: Epidemiology and Biostatistics,
Keywords: The new rural cooperative medical care The elderly population Health Services Fairness
CLC: R197.1
Type: Master's thesis
Year: 2011
Downloads: 60
Quote: 2
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Abstract


Objective: to study and objective evaluation of the dynamic new rural cooperative medical system in Jiangxi Province pilot areas fairness elderly population health status and service trends. For the inequity that exists in reality in-depth analysis, analysis of health services in rural elderly fairness missing reality and institutional reasons, put forward relevant policy recommendations to further improve the health care system to provide a scientific basis. Methods: A multi-stage stratified random sampling method, Jiangxi Province, a total of three counties 9 Township 27 administrative villages of sample units, each of 70 randomly selected residents of the village as the research object. By the fifth consecutive year follow-up investigation, the sample was divided into elderly and non-elderly population, income and then divided into five groups, from the provision, utilization, health outcomes, financing and other four areas are discussed in longitudinal comparative study in order to focus index (CI) , the slope index of inequality (S Ⅱ), use / need ratio and Kakwani index as the evaluation index, using the comprehensive index method for elderly health services overall change in equity of a comprehensive evaluation. Results: 1, to provide fairness: five surveys provide a fair value of each index C Ⅰ are close to 0, C Ⅰ and S Ⅱ absolute value increased first and then decreased. Farmers distance of residence from medical lt; 1 kilometer proportions and different economic layers farmers on the new rural cooperative medical institutions show a downward trend in attitude, good quality and better evaluation of the proportion of the rise. 2, the use of fairness: the elderly population is not due to financial difficulties in addition to the proportion of visits, hospitalizations due to economic difficulties are not greater than the absolute value of the proportion of C Ⅰ 03, the rest of the indicators are less than 0.2, but two weeks is not attendance rate, because of financial difficulties did not visit proportion of not requiring hospitalization hospitalization rates, the proportion of non-hospitalized due to financial difficulties of the absolute value of C Ⅰ and S Ⅱ showed an upward trend. Use / need more than the rise. Two weeks attendance rate, the proportion of treatment due to financial difficulties did not, did not require hospitalization hospitalization rates, hospitalization rates due to economic difficulties is not a downward trend, the annual hospitalization rate rise. Non-elderly population in addition to the absolute value of each C Ⅰ 2010 the proportion of treatment due to financial difficulties did not, the rest are less than 0.3, in addition to the proportion of non-hospitalized because of financial difficulties C Ⅰ and S Ⅱ absolute declining, other indicators showed an upward trend. Use / need more than the rise. Annual hospitalization rate showed an upward trend; two weeks attendance rate, two weeks is not attendance rate, did not require hospitalization hospitalization rates declined. 3, the fairness of health outcomes: the elderly population of the C Ⅰ and S Ⅱ absolute rise. Two weeks prevalence rate of two weeks in bed, stay in bed for two weeks showed a downward trend in the number of days. Six months prevalence of chronic diseases on the rise. Non-elderly group C Ⅰ and S Ⅱ absolute decline. Two weeks prevalence rate of two weeks in bed, stay in bed for two weeks the number of days, two weeks off work (study) showed a downward trend in the number of days, two weeks off work (school) rates rise. 4, the fairness of health financing: five surveys in the elderly population and the non-elderly population pays per capita outpatient costs, annual per capita cost of hospitalization and annual pay-pocket health care costs per capita showed overall upward trend, but its share of the annual per capita proportion of net income decreased. Five surveys per capita pays outpatient, hospital fees and medical expenses as a percentage of total revenue per capita and economic conditions are negatively correlated. Five surveys per capita hospital costs and pays the total cost of Kakwani indices are negative. In addition to the total non-elderly population pays medical expenses Kakwani index fell, the rest of the rise. 5, the elderly and non-elderly peasant economies layer composite index for health services in general have risen. Elderly population overall fairness of the five surveys were less than the absolute value of C Ⅰ 0.2,2010 best years (-0.0143), 2007 Worst (0.1060); non-elderly population overall fairness of the five surveys were less than the absolute value of C Ⅰ 0.1,2007 years Best (-0.0017), 2006 Worst (0.0328). However, elderly and non-elderly population overall concentration index difference was not statistically significant. Conclusions: 1, farmers medical shorter distances, for the designated medical institutions and health services are more satisfied with the attitude and quality of service, but the service attitude of satisfaction decline. 2, the elderly population overall fairness of health service utilization in good condition, but the degree of utilization is still lower than non-elderly population, low-income population health service utilization fairness issues need attention. 3, the elderly population in general good health outcomes fairness, fairness is still lower than non-elderly population, the implementation of the new rural cooperative health outcomes for farmers in order to positively influence the fairness based. 4, the elderly population is unfair funding situation has improved, but has not yet changed the funding mechanism regressive state NCMS funding fairness needs to be further strengthened. 5, after the implementation of the new rural cooperative, the elderly population has increased the overall level of health services, health services, better overall fairness.

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CLC: > Medicine, health > Preventive Medicine,Health > Health care organizations and career ( Health Management ) > Health care systems and institutions > Health care system
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