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The Ecology Of Medical Care In Beijing

1447 words - 6 pages

Abstract
Background

We presented the pattern of health care consumption, and the utilization of available resources by describing the ecology of medical care in Beijing on a monthly basis and by describing the socio-demographic characteristics associated with receipt care in different settings.
Methods

A cohort of 6,592 adults, 15 years of age and older were sampled to estimate the number of urban-resident adults per 1,000 who visited a medical facility at least once in a month, by the method of three-stage stratified and cluster random sampling. Separate logistic regression analyses assessed the association between those receiving care in different types of setting and their ...view middle of the document...

Understanding ecological relationships can also guide assessments of the adequacy, effectiveness, efficiency and appropriateness of the existing health care resources [3,4].

In the last few decades, several reports assessed the progress of China’s healthcare delivery systems, in the wake of rapid economic growth, poverty reduction, significantly increased life expectancy, massively decreased infant mortality rate, and burgeoning healthcare coverage [5]. However these reports also indicated that China’s health outcome has exhibited several undesirable features: such as growing inequalities in access to health care and different health status across regions of different socioeconomic standings and between urban and rural areas. Hospital commercialization and deficiencies in the supply of medical care have driven up the cost of medical care delivery, thus further increased the barrier to access of medical care [6-8].

Facing a series of deeply rooted problems, Chinese government undertook phased measures in 2009 to achieve universal health care coverage by 2020 [9]. In the first phase of 2009 to 2011, the reform is anchored in five interdependent areas: expanding coverage to insure more than 90% of the population, establishing a national essential medicines system to meet everyone’s primary needs of medicine, improving the primary care delivery system to provide basic health care and to manage referrals to specialist care and hospitals, making public health services available and equal for all, and piloting public hospital reforms [10,11]. The data of National Health Services Survey (NHSS) reported that an impressive expansion of medical insurance coverage has increased from 29.7% in 2003 to 95.7% in 2011, covering about 1.28 billion people, and narrowing the inequality-gaps in accessing health services between rural and urban areas. However, increased insurance coverage has not yet been effective in reducing patients’ financial risks, as both health expenditure and out-of-pocket payments continue to rise rapidly. In 2011, the inpatient reimbursement level was relatively modest, about 50%, and 13% of households reported catastrophic health expenditures, showing health expenses as a percentage of total household expenditure continue to increase after the 2009 health reform [12]. During the first period, most of the researches drew attention to developments made in several areas of health system reform (HSR), but none of the reports attempted to predict progress towards achieving the major HSR objective, which is equitable and affordable access to quality health service.

In this study, we applied the quantitative socio-epidemiology method to quantify the variation among the subsets of Beijing population seeking medical care in one month and analyzed the influences of illness on the care seeking behavior of the population.
Materials and Methods
Ethics Statement

The study was approved by the Ethical Committee of Capital Medical University,...

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