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Construction Andapplication of New Cooperative Medical System’s Welfare Evaluating Index

Author: ZouHouDong
Tutor: ZhangZuoZuo
School: Second Military Medical University
Course: Social Medicine and Health Management
Keywords: The new type of rural cooperative medical care Welfare Evaluation Empirical Analysis Residents ' satisfaction
CLC: R197.1
Type: Master's thesis
Year: 2011
Downloads: 157
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Abstract

The context of a market economy, the rural residents' medical treatment is difficult, expensive medical treatment \the reform and development of the new type of rural cooperative medical care became the focus of attention and focus from all walks of life. To this end, the party's congress determine the \reiterated that \proposed adhere to public health, public welfare nature, stressed that health is the basis of comprehensive development of the health industry to adapt to the new situation and to establish a basic medical and health system covering both urban and rural residents, to provide people with a safe, effective, convenient, inexpensive public health for health system reform, China is about to unfold, and the future health and basic medical services, pointed out the direction, and as one of the basic content of the national economic construction and economic reform. According to the statistics of the Ministry of Health, as of the end of 2009, China carried out the new rural cooperative counties (cities, districts) have reached the number of 2716, the number has reached 833 million people participate in the new rural cooperative, to new rural cooperative based rural health safety net initially established. The Government hopes that by strengthening the new rural cooperative security network, increase the compensation efforts, comprehensive coverage of basic health services in rural areas to the rural population, thus fundamentally solve the problem of the rural population \This will help speed up the development of rural health service system, establish and improve rural health service network. However NRCMS eight years since the implementation of the rural health service system in the policy in favor of government resources support farmers to obtain welfare? High government investment to improve the medical treatment of rural population status? NCMS promote rural health services how the development of the system? NCMS How to improve the satisfaction of the farmers of the rural health service system? These are rural health policy research focus. Objective: In this study, the National Natural Science Foundation of China, \Follow the guiding ideology of \rural health development and new rural cooperative implementation of the actual focus of the new rural cooperative welfare evaluation no universally recognized evaluation, can not meet the new rural cooperative run the day-to-day monitoring and evaluation, comprehensive use of the Delphi method and fuzzy comprehensive judgment method, to build China's new rural cooperative evaluation of farmers' welfare, the economy can be a doctor and, medical resources and sexual resident satisfaction indicators Empirical Analysis, \residents' satisfaction with the status quo and influencing factors in the evaluation of the welfare of farmers welfare methodological guidance for the executive branch of government oversight and evaluation of new agricultural and new rural cooperative farmers welfare improvements to make policy recommendations. Methods: In this study, NCMS welfare status-oriented, integrated use of literature review method, expert the argumentation method and Delphi method to build a new rural cooperative evaluation of welfare. Then through fuzzy comprehensive judgment method to determine the comprehensive evaluation index weight coefficient. Descriptive statistics, univariate analysis, the empirical analysis of multivariate logistic analysis of the new rural cooperative farmers 'welfare evaluation of residents' satisfaction. Results: through the series of research activities, the study made the following findings: 1, build important structural level of medical care utilization and sexual health care resources, and residents' satisfaction with the three main types of indicators sexual welfare evaluation indicators, a doctor of economic and sexual mainly include individual farmers turned over to the new rural cooperative fund in place rate, parameters together by the new rural cooperative fund per capita real have the amount, the government for the poor participate in co-assistance payments fulfillment rate, budgets at all levels The total financing ratio, and fund utilization the 15 the subordinates indicators; medical resources available, including a number of health institutions, health institutions scale per thousand medical personnel number, number of beds and six subordinates indicators per thousand population; residents' satisfaction The indicators include six subordinate organization publicity satisfaction rate, the fund management satisfaction rate fund supervision satisfaction rate compensation program satisfaction rate indicators. The survey results of the Delphi method: (1) the degree of active: two letter of inquiry sent questionnaires to 28, to recover the 24, 24 valid questionnaires were effectively back to set an example for the 85.70% positive coefficient of experts. (2) The authority of the coefficient: medical care utilization, the authority coefficient medical resources available, and sexual and residents' satisfaction with three indicators were 0.8894,0.8894,0.8547, an average of 0.8744, higher coefficient authority. (3) coordination factor: a doctor of economic availability of medical resources availability and resident satisfaction coordination coefficient were 0.3591, 0.5466, 0.3236, chi-square test of coordination coefficient conclusions are P lt; 0.05, expert advice on the degree of coordination than the high. The experts have not made a lot of modifications indicators that basic reasonable set of indicators in general. (4) the right to re-factor: fuzzy comprehensive judgment method to calculate the medical care utilization can and sexual health care resources available, and sexual and resident satisfaction evaluation indicators, specific indicators of the weighting coefficient is relatively accurate, but due to the above-mentioned three evaluation indicators of lower-level indicators There are as many as 27, and its specific weight coefficient will not be described in detail. 3, of the new rural cooperative medical economic welfare indicators, the availability of medical resources, residents' satisfaction with three indicators were empirical analysis results show that the sample data in the medical treatment of economic and sexual (in 2005 the Ministry of Health the NCMS survey agencies survey data conducted jointly with the World Bank) and the medical resources and sexual health statistics in China (2005) were poor, and the satisfaction of the residents (Qingpu District data field investigation in March 2011 ) is better, and the the resident satisfaction depth analysis shows: the participation of the new rural cooperative very satisfied and 30, accounting for 24.59%; answered satisfactory 82 people, accounting for 67.21%; answering 10 general, accounting for 8.20 %; answered dissatisfied 0, accounting for 0.00%; to answer very dissatisfied, accounting for 0.00%, higher satisfaction, Qingpu District, the new rural cooperative work better. From single factor analysis results, participation by age, level of education, occupation and from the nearest medical unit at different distances can affect participation by satisfaction. Logistic regression analysis shows that participation from the nearest medical unit time, households a year of living expenses and whether the local poor households or low households affect satisfaction. Proposed to enhance the new rural cooperative participation welfare of farmers from the four aspects of the legislation, financing, supervision of funds, and to increase investment in rural health services and specifications designated medical institutions, medical service behavior. Conclusions: 1. Evaluation wide coverage with routine, effectiveness, development and practical features. 2. Reasonable evaluation of screening methods, the method of determining the weight coefficient scientific, accurate results. 3. NRCMS welfare is affected by a variety of factors should be legislation, financing, fund regulatory and increase investment in rural health services and specification designated medical institutions, medical service behavior in four areas to enhance the new rural cooperative participation welfare of farmers.

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