ABSTRACT
Objective To study the participating farmers'interest demands for NRCMs in order to provide basis for the payment system reform based on the demand side perspective. Methods A cross-sectional study was conducted from September 2016 to February 2017. Multi-stage stratified random sampling was conducted in six counties of three provinces in the eastern, middle and western regions of China. Mathematical statistics analysis was conducted to clarify the interest demands and influencing factors of the participating farmers. Results The interests claims of the 1 452 participating farmers were to improve service quality, to reduce the economic burden of disease, and to standardize the management. The medians found were 4.00, 4.00 and 3.63 respectively. Relative to the flat rate, the DRGs raised higher requirements for standardized medical behaviors offered by the medical workers. Furthermore, it called for effective medical quality supervision, rigorous control of medical costs and highly scientific and standardized management. The differences were statistically significant ( P ＜0.05 ). Conclusions The diversity of participating farmers'interest demands deserves due attention, the payment methods combination should fit local needs, the interests demands expression channel of the participants should be expanded, and the demand side deserves a due role in supervision of the funds.
ABSTRACT
Objective To study doctor-patient interest demands satisfaction and its influencing factors of the payment system reform of the new rural cooperative medical care scheme to provide reference for the reform. Methods Cross-sectional survey was conducted from September 2016 to February 2017. Multi-stage stratified random sampling was used in six counties of three provinces in the eastern, middle and western regions of China, and mathematical statistics was applied to analyze the data. Results The doctor-patient overall interest demands satisfaction was high, but the satisfaction was lower both with the income and ability improvement of medical staff and with the benefits of farmers. The influencing factors of the satisfaction of managers in medical institutions included the type of payment, educational level and work unit (P＜0.05). The influencing factors of medical staff's satisfaction included the type of payment, work unit, and working years among others(P＜0.05). The influencing factors of farmers'satisfaction included the type of payment and the average annual income, etc(P＜0.05). Conclusions The core interest demands of both doctors and patients should be valued to enhance their satisfaction. Diseases related groups should be promoted and applied scientifically, and appropriately integrated with other methods of payment. Both doctors and patients'understanding of the payment reform should be improved by propaganda and training, to get their support and cooperation.
ABSTRACT
Based on synergetics, system theory and dissipative structure theory, the connotation and composition of the compound system of rural public health service in country area are described in the paper. The authors proposed that the synergy degree model of the compound system for rural public health service in county areas comprises the order degree model and the synergy degree model of the compound system, which are composed of such subsystems as functionality, service network, demand, and economy. They also probed into the evaluation method for synergy degree and built the measuring index system of synergy degree comprising 59 level-2 evaluation indicators.
ABSTRACT
Objective To measure and analyze the order degree of the internal subsystems and the synergetic degree of the compound system of rural public health service in county areas based on the synergy model of the compound system. Methods According to the distribution of eastern, central and western regions in China, Xiangshan county in Zhejiang province, Wuzhi county in Henan province and Bin county in Shaanxi province were sampled. Based on the index system of synergetic degree measurement including the 52 level-2 evaluation indicators, a questionnaire survey was used to measure the synergetic degree of the compound system of rural public health service in county areas. Results The highest synergetic degrees of the compound system of rural public health service in Xiangshan county, Wuzhi county and Bin county were only 0. 18153, 0. 18068 and 0. 21312 respectively. This indicated the synergy at a low degree. And the synergy of the supply-demand system was an important influential factor for synergy of this compound system, as their development trends were consistent basically. Conclusions The synergy model of the compound system can play a useful role in rural public health service system in county areas. The demand of rural residents deserves more attention and the difference between the service supply and demand should be reduced.