Rural Cooperative Medical Care System Research Articles

Developing a Rural Healthcare System

Background: Healthcare related welfare is a matter of resource allocation. In modern market economies, redistribution in Western societies is accomplished through state welfare systems to balance the inequality of market resource allocation. However, resource allocation in socialist countries has its own peculiarities. And the relationship between market transformation (social transformation) and resource allocation methods in post-socialist countries is an important academic topic. This paper examines the changes in the rural cooperative medical system（RCMS）in China in order to explore the changes in rural cooperative healthcare governance mechanisms during recent social transformation. Objectives: The main purpose of this paper is to place the rural cooperative health care system（RCMS）in a macroeconomic-political context and to compare the changes in cooperative health care resource allocation mechanisms across time. Methods: The article undertakes a narrative literature review approach and method. The review used the following sources: Web of Science and PubMed. The search used the keywords" rural cooperative medical care system", "community benefits", " public service-based welfare" and "governance",and limited to articles published between January 2019 and June 2022. The selection of articles was based on the inclusion/exclusion criteria (keywords defined and time span of publication). Results: From collectivized cooperative medical care System（RCMS） to today's New Rural Cooperative Medical System（NRCMS), its governance mechanism has changed and the nature of welfare has changed with it. It has also changed from community welfare, where organized grassroots communities supply medical services, to government-led public service-based welfare. Main Contribution to Evidence-Based Practice: The paper shows the process of change in China's rural cooperative healthcarel system（RCMS), mainly analyzing the change of healthcare welfare governance mechanism. Thus ,it provides a reference for governmental health policies development and for international researchers.

Does health insurance promote people's consumption? New evidence from China

In order to change the situation that reimbursement rate of the new rural cooperative medical care system (NCMS) was too low to alleviate farmers medical burden, in August 2012, China began to expand the coverage of the NCMS to include the treatment of critical illnesses. Could more effective health insurance promote the consumption of rural residents? We studied the impact of the critical illness insurance (CII) on rural household consumption, and find that the CII increases per capita household daily consumption by >15%. But healthcare and medical expenditures have not been affected. Our comparison of outcomes for households with different levels of consumption and income shows the CII mainly promote the consumption of rural affluent family, but no incentive for poor family, resulting in deterioration of consumption inequality of rural households. The finding is robust to various alternative hypotheses and specifications.

Barefoot Doctors and the “Health Care Revolution” in Rural China: A Study Centered on Shandong Province

Barefoot doctors were rural medical personnel trained en masse, whose emergence and development had a particular political, economic, social, and cultural background. Like the rural cooperative medical care system, the barefoot doctor was a well-known phenomenon in the Cultural Revolution. Complicated regional differences and a lack of reliable sources create much difficulty for the study of barefoot doctors and result in differing opinions of their status and importance. Some scholars greatly admire barefoot doctors, whereas others harshly criticize them. This paper explores the rise and development of barefoot doctors based on a case study of Shandong province. I argue that the promotion of barefoot doctors was a consequence of the medical education revolution and an implementation of the Cultural Revolution in rural public health care, which significantly influenced medical services and development in rural areas. First, barefoot doctors played a significant role in accomplishing the first rural health care revolution by providing primary health care to peasants and eliminating endemic and infectious illnesses. Second, barefoot doctors were the agents who integrated Western and Chinese medicines under the direction of the state. As an essential part of the rural cooperative medical system, barefoot doctor personnel grew in number with the system's implementation. After the Cultural Revolution ended, the cooperative medical system began to disintegrate-a process that accelerated in the 1980s until the system's collapse in the wake of the de-collectivization. As a result, the number of barefoot doctors also ran down steadily. In 1985, "barefoot doctor" as a job title was officially removed from Chinese medical profession, demonstrating that its practice was non-universal and unsustainable.

Pediatric Medical Care System in China Has Significantly Reduced Abandonment of Acute Lymphoblastic Leukemia Treatment.

In this study, we have analyzed both administrative and clinical data from our hospital during 2002 to 2012 to evaluate the influence of government medical policies on reducing abandonment treatment in pediatric patients with acute lymphoblastic leukemia. Two policies funding for the catastrophic diseases and the new rural cooperative medical care system (NRCMS) were initiated in 2005 and 2011, respectively. About 1151 children diagnosed with acute lymphoblastic leukemia were enrolled in our study during this period and 316 cases abandoned treatment. Statistical differences in sex, age, number of children in the family, and family financial status were observed. Of most importance, the medical insurance coverage was critical for reducing abandonment treatment. However, 92 cases abandoning treatment after relapse did not show significant difference either in medical insurance coverage or in duration from first complete remission. In conclusion, financial crisis was the main reason for abandoning treatment. Government-funded health care expenditure programs reduced families’ economic burden and thereby reduced the abandonment rate with resultant increased overall survival.

What limits the utilization of health services among the rural population in the Dabie Mountains- evidence from Hubei province, China?

BackgroundIndividuals living in rural mountain areas tend to use health services less to manage discomfort or illness. This study aims to identify the variables that best explain the health service utilization of a sample of the rural population in the Dabie Mountains in China.MethodsTo obtain information about health service utilization, a cross-sectional household survey was conducted using face-to-face interviews among the residents of a poor town in the Dabie Mountains. A total of 1,003 residents aged 15 or more, who had felt unwell in the last two weeks before the survey, were included in the analysis. The χ2 test and binary logistic regression were used to analyze the factors influencing health service utilization.ResultsA total of 51.2% of those surveyed had not used health services when they felt unwell, higher than the data reported in the 4th National Health Services Survey of China. Enabling variables played an important role in predicting the utilization of health services. Factors associated with increased health service utilization included being younger, travelling longer to the nearest clinic, and higher household net income.ConclusionTo reduce disparities in health service utilization, (1) some effort should be made to change the perceptions and attitudes of older people; (2) reimbursement levels of the New Rural Cooperative Medical Care System should be improved to reduce economic barriers to health service utilization.

The Study of Cloud Computing Data Interaction Platform on the New Type of Rural Cooperative Medical Care System

Cloud computing is mainly studied and applied in data-intensive industries. It is rarely seen in the medical industry, though it is the most representative one of data-intensive industries and closely related to people's lives. There is no medical data interaction platform of cloud computing. This paper introduces the framework of cloud computing data interaction platform for the new rural cooperative medical care system (NCSM), which will allow for NCMS data interaction on this interactive platform.

POLICY CHANGE AND EXPERT INVOLVEMENT IN CHINA

Expert involvement is usually regarded as one of the causes of policy changes. However, how does the nature of policy change, in turn, influence expert involvement? This study constructs an analytical model by adopting and developing policy network and principal‐agent theories, suggesting that expert involvement can be regarded as the result of the inherent characteristics of policy change in the Chinese policy process. Two key characteristics of policy change, namely ‘loss embeddedness' and ‘knowledge complexity’, are employed to form four types of policy changes. Empirically, a comparative study with four policy change cases illustrates that Chinese experts adopt four behavioural strategies, such as linear access, outside‐in enlightenment, deprofessionalized campaign, and locked‐out, in different types of policy change. These policy change cases include the new‐type rural cooperative medical care system, the new urban medical care system, revocation of detention and repatriation system, and the new economically affordable urban housing policy.

Emerging issues in public health: A perspective on China’s healthcare system

China's expenditure on healthcare has increased dramatically over the last 20 years, and three broad trends are seen in the associated health outcomes. First, limited improvements have been achieved to aggregate high-level health outcomes, e.g. infant mortality. Second, development of large and widening health inequalities associated with disparate wealth between provinces and a rural-urban divide. Finally, the burden of disease is shifting from predominantly communicable diseases to chronic diseases. Reasons for the limited gains from investment in healthcare are identified as: (1) increased out-of-pocket expenditure including a high proportion of catastrophic expenditure; (2) a geographical imbalance in healthcare spending, focusing on secondary and tertiary hospital care and greater expenditure on urban centres compared with rural centres; and (3) the commercialization of healthcare without adequate attention to cost control, which has led to escalation of prices and decreased efficiency. Recently, the Chinese Government has initiated widespread reform. Three key policy responses are to establish rural health insurance, partly funded by the Government (the New Rural Co-operative Medical Care System); to develop community health centres; and to aspire to universal basic healthcare coverage by 2020 (Healthy China 2020).

A Present Situation of the Rural Medical Seculity System in the China

Rural in medical care one of most important problems in China since it relates to the health care of over half of China's population. Under such severe circumstances, China's government started to bring new rural cooperative medical care system into effect since the beginning of 21st century. It had been six crucial years until 2003 for The New Rural Cooperative Medical System (NRCMS) , which has achieved good results. But the system has been encountered lots of problems and need to be continuously improved as an innovative one.This article analyzes the present situation of the medical security system in the China, which consists of two chapters. The first is to explain the medical system of China in terms of setup, development, promotion and decline from historical point of view. The second is to investigate the implementation and problems of the new rural cooperatives medical system. As most of the farmer does not trust the NRCMS, and safeguard level it seems difficult for the cooperative medical treatment has difficulties to adapt various medical safeguard demands.