The effect of the new health care reform policy on the medical equity

Objective:To investigate the effects of new health care reform policy on health equity from the resident's perspective.Methods:The health service fairness in 2 737 urban and rural residents in Anhui province were investigated by the self-designed questionnaire"the Questionnaire on New Medical Reform Policy Performance from Urban and Rural Resident's Evalution"using the convenience sampling method.Results:Among the fair indicators of health,the residents were divided into the <1 000 yuan group,1 000 to 3 000 group,>3 000 to 5 000 and >5 000 group according to their income,the two weeks prevalence rates in four groups were 36.8%,26.8%,26.8% and 22.3%,respectively.The prevalence rates of the chronic diseases in four groups were 24.6%,18.3%,17.7% and 18.3%,respectively.The differences of the two weeks prevalence rates and prevalence rates of chronic diseases in four groups were statistically significant(P<0.01),which increased with the decreasing of income.Logistic regression model showed that the age and average family income were the risk factors of two weeks prevalence rates,and the age,culture degree,marital status,average family income and payment were the risk factors of chronic illnesses.Among the equitable index of health service utilization,the visit rates in four groups were 13.1%,9.4%,10.1% and 6.9%,respectively,and the hospitalization rates of past year in four groups were 7.2%,4.5%,4.4% and 2.3%,respectively.The differences of the visit rates of two weeks and hospitalization rates in four groups were statistically significant(P<0.05).Logistic regression model showed the visit rates of two weeks increased with culture degree increasing.Among the fairness index of health financing,the own expense proportion dropped and the public expense proportion increased.Conclusions:The need of health service in different health status of urban and rural residents is different,low income families need more.Residents mainly chose villages and towns/community health service center,and the public health service demand and utilization have been improved.The health financing is unfair in a certain degree.