| The health services include input, process and output. Nearly each component encompasses the person, finance, material, time and information, etc. So the extension of quality of health care is very broad, it includes many aspects. At present there is not a generally accepted practical "working definition" for quality in health care.WHO regards that the quality of health care is defined as"the totality of all the properties and characteristics of a product or a service which make it suitable to meet the expressed or implicit needs". The characteristic is a significant identified sign between the health service and other service. The concept of health care quality is a comprehensive, diversity, relativity and development continuously.There exist enormous discrepancy between the economics,system,life style among the nations, together with the specific property determined that the evaluation of health care is a complicated and multidimensional thing. Each country even if the same country lies in the different development stage has different connotation of health care quality. So there is various evaluation indicators and standards of health care quality and there isn't a universal solve scheme.Long practice experience showed that the improvement of health carequality isn't an unaided solved problem. It is one of the components of the whole society. Many factors are related to the quality of health care. So when every country settled down evaluation quality indicators and standards have to consider their situation. That is the main reason why we conduct the deep research in this field.The objects of this study: We want to set up the evaluation indicators of health care quality in our country. Using these indicators, we assessed the quality of health care of Shaanxi Province.The data resources: The data comes from the national health services survey (household questionnaire survey). In 1993, 1998 and 2003(Shaanxi Province).Results:A brief introduction to the Shaanxi Province: Shaanxi Province lies in the west of China and it has 205.8 thousands of square km. By the end of year 2003, there are 36895 thousands of people in Shaanxi Province. The people of rural and urban are accounts for 67.26%, 32.74%, respectively. The average per Capita annual income is 1556 yuan and 4175 yuan, respectively. The income is lower 28.5% than the average level of whole rural and lower 38.7% than the average level of whole urban. The age of 65 years old or above accounts for 12.5% in urban and 6.1% in rural. According to international standard (7%), we can confer that the population of urban is entered into aging population society. The illiterate or half illiterate accounts for 19.2% in rural. The proportional of annual medical expenditure accounts for total expenditure is higher than the average level of whole country. 68.4% household is drinking unclean water and 98.6% household is short of safe toilet room in rural area. The coverage rate of medical insurance is descending in urban. More and more inhabitants pay medical fees at their own expense.The evaluation indicators of health care quality: Several factors such as access,responsiveness, equity, timeliness, safety, technical and efficient are indispensable factors in evaluation. (1)Access: access to health care means having "the timely use of personnel health services to achieve the best health outcomes". It is an importance sign of equity of health care. It includes spatial access, non-spatial access and service access. The evaluation indicators of spatial access are the distance or time to the proximate clinical, the distribution of community services and radius. The indicators of evaluation economical access are coverage rate of health insurance, the protional of self-pay, the standard of self-pay, the economical conditions, the percentage of a outpatient cost once taken in per Captia annual income, the percentage of an inpatient cost once taken in per Captia annual income, the percentage of non-utilization inpatient service among the inpatients' need and the percentage of non-use inpatient service due to poor. The service access can be divided into the clinical medical service and preventive medical service. The evaluation indicators of clinical medical service are outpatient visit rate, distribution of outpatient unit, the times of outpatient visit, non-utilization of outpatient visit, the reasons of non-utilization outpatient, the expenditure of outpatient per person, the inpatient visit rate, non-inpatient utilization rate and inpatient cost level. When we assessed the preventive medical service, we can use the visit times of pregnant women, the visit times after delivery, the protional of breast feed, the amount of enroll children, the injection rate of vaccine to evaluate. (2)Equitabity: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status. Equity is a major criterion for evaluating the performance of health care system and health care reform proposals. We can use the rate difference, GINI coefficient, ID, SII, RII and DALE to evaluate. (3)Timely: Reducing waits and sometimes harmful delays for both those whoreceive and those who give care. We can use the waiting time in emergency or non-emergency, the time of ambulance get to the first-aid scene, the pecent of AMI who received the Aspirin treatment with 24hrs addimition and the percent of pneumonia patient who received the anti-inflammation after 4hrs be hospitalized. (4) Safety: Avoiding injuries to patients from the care that is intend to help them. We can use the medicine adverse effect, aquired hospital infection, transfusion reaction, the foreign things left in the body, embolism after sugery to assess. (5) Responsiveness and satisfaction: WHO considered the responsiveness of health system can be divided into two parts, namely the respect and patient-centered. In evaluating the respect, we can use the dignity, confidentiality, autonomy to evaluate. The indicators of patient-centered include prompt attention,social support networks,quality of basic amenities quality and choice of provoders.Considering our country situation, we added the convenience of the inquiry the fee and request. (6)Efficient: Avoiding waste, including waste of equipment, suppliers, ideas, energy. We can use the annual outpatients by a doctor cured, the annual inpatients by a doctor cured, working days of a bed in a year and equipment utilization. (7)Effective: We can analyse the trends of mortality, morbidity and average life-span.Evaluation of quality of health care in Shaanxi Province: The results showed that (1) the health service is inequity. (2)The responsiveness is poor. Worse of all, the inquiry the fee and request are very inconvenient. There are 25% outpatients and 38% inpatients who are satisfied with their service. The most dissatisfication is the high medical fee. (3) The access to health care is poor, particularly in the rural area. There are 11% people whose distance to the proximate clinic is far away 5km or more and they have to spend at least 30 minutes to the clinic. That is to say, the physical access is poor. In addition to the price of medical fee is high,...
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