A Comparative Analysis of the Rural and Urban Older Victims of the 5.12 Sichuan Earthquake
Abstract Older people are particularly vulnerable to the impacts of natural disasters but their needs are often neglected in post-disaster aid work. Even less known is how the challenges faced by rural residents differ from those faced by urban residents, due to the relative lack of support infrastructure (e.g., medical services) in rural areas, particularly in developing countries. We report here a needs assessment survey of the needs of 150 older victims of the recent earthquake in Sichuan, China, with a specific focus on the comparison between urban and rural residents. Case studies were used to provide more in-depth illustrations where appropriate. The findings revealed a variety of unmet needs, both tangible and intangible, of the older victims. The majority of the victims expressed worries about not being able to afford housing, basic necessities, and long-term medical care. Such worries were noticeably more pronounced among rural than urban residents. Besides, many participants suffered loss of multiple family members and were still in a state of grief. The needs of the victims were discussed in the context of China's disaster relief policies, as well as differential social protection policies for urban and rural residents.
Evaluation of the new rural cooperative medical system in China: is it working or not?
BackgroundTo prove the possibility of implementing the New Rural Cooperative Medical System (NRCMS) at different levels with a premium funding according to their economic level in developed and less developed areas in Guangdong province, and study the insurable inpatients in different types of regions, taking into account limitations of indemnities and loss ratios.MethodAll data samples were randomly collected from the NRCMS Department, Guangdong Province. Gross domestic product (GDP) at 10000 Yuan per capita was employed to divide Guangdong into two economic levels: (1) economically developed & (2) less economically developed regions. A descriptive analysis about tendency of raising premium and reimbursement ratios of common fund was performed with independent samples and t-test as well as implementing a model to evaluate the differences in premium contribution differences in co-payments, thresholds, and rebates. Also, a qualitative study measured several economic factors to evaluate farmers' financial and social potency in contributing to the NRCMS.ResultA higher GDP per capita were found within economically developed regions (p < 0.05) than in less developed areas, with higher tendency for funding capacity and average funding capability in villages and towns within economically developed regions (p < 0.05) than in economically less developed. Maximum benefits between two regions in medical insurance coverage showed significant difference (p < 0.05); differences between basic medical insurance coverage between two regions was insignificant (p > 0.05); nevertheless, economically developed regions showed higher threshold and rebates with less co-payments in the economically developed than less developed.ConclusionDespite some loop holes in the NRCMS, the system is workable, but needs more strengthening by encouraging farmers' participation into NRCMS with a necessity to implement a new reimbursement payment system by health care providers. In addition it is proposed that for maximum benefits another premium funding should be secured.
Service utilization in community health centers in China: a comparison analysis with local hospitals
BackgroundBeing an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs) have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services.MethodsThe study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1). Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA.ResultsThe six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them.ConclusionThe community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.