Research On The Quality Chain Of Vertical Continuity Of Care In Basic Medical Service Net Of Rural Area

1. Significant of researchThe state of basic medical service net of rural area and its quality in China could be discribed as "system dysfunction" and "quality chasm". This paper is mainly about the theory building and evaluation of the Quality Chain of Vertical Continuity of Care in Basic Medical Service net in China. The topic selection is based on the research of medical quality evaluation which belongs to the Health Management. This paper, from a whole new aspect, built the key indicators for the Vertical Continuity of Health Care(VCOC). In the meanwhile, to analyze the situation of VCOC in rural areas based on these indicators,then put forwarded the policy proposals.2. Objectives of researchThis research, which based on the theories of Health Management, System Analysis Engineering, built the framework of the key evaluation indicators from three aspects which including safety, economy and the continuity of information transmit. To describe the current situation of VCOC, especially the issues on the system and structure of health, which using the framework mentioned before. By probing and exploring the possible influential factors, to find out the cause of medical service system and key nodes of structure, in order to provide the theory and technical suppor in the field of system quality analysis of medical care in China.3. The Resource of data and Method.The data comes from the data which was released by government, Health Statistics Yearbook, Literature database in China and overseas, field investigation data and expert interview material, etc. Using the theory of literature retrieval, literature logic analysis and other methods, the combined system engineering, and public policy science, health service management and related discipline theory analysis; Data of field investigation was analyzed by health statistics processing. statistical analysis software SPSS12.0was used for analysis.4. Contents4.1By the analyzing of China's rural basic medical service network organization connotation, combined with the theory of system, this paper expounds the connotation and denotation of continuity health service and continuity medical service, longitudinal continuity medical service, quality of chains, and other concepts. Initially constructs the rural basic medical service network in the quality chain theory of VCOC.4.2According to the set of quality chain of VCOC theory, combined with the current state of China's rural tertiary prevention health network, established the VCOC quality evaluation key indicators from the dimensions of safety, economy and information transmission for empirical research provides theory basis.4.3By the empirical research, to evaluate the quality chain of basic medical service net in rural from safety, economy and information transmission. The results found that there are many service safety problems in VCOC of China's rural basic medical service network, such as antibiotic is not reasonable using which involved in more institutions which related to VCOC; The VCOC process, because of unreasonable repeat examinations in hospital, rural patients caused by the more serious economic impact; The continuity of information transfer and sharing in the rural medical service in the process also has serious fracture. In general, our country rural basic medical service network in the vertical continuity medical service quality is low, and the researchers and policy makers should show their deep concern.5. Discussion and Suggestion By the analysis of causes and affecting factors of present situation of rural vertical continuity medical service quality, the following conclusion was drew:whether the researchers or policy makers, needs the "integrate view" to survey quality problems existing in China's rural basic medical service system. The quality chain is occurring "rupture" mainly because of the tendency of medical science's specialized, the system fault of medical insurance system in maintaining and promoting the service in the process of integration and the absence of information chain rupture--"information island" formation.In view of the above situation, the researcher put forward some suggestions from the view of organizational change,mechanism innovation and information construction of both the suppliers and the patient. Believe that the government and medical institutions'managers must break the ideas of service in single institutions only, to provide the reform in the view of system integration, continuity of management, to reshape the mechanism of continuity of internal and external service. at the same time, in information technology innovation and use, to improve the quality of VCOC with the changing of both the suppliers and patients,, forming a high quality of the vertical continuity medical service.6. Innovations and the shortcomings of this studyLiterature review conclusion shows that the researchers always focus on the quality research of single institution in rural medical service, but rare to talk about the VCOC service and its quality by using the new evaluation index and quantitative and qualitative analysis methods. In addition, the application of methodology also has a certain innovation because of the application of system engineering. However, the limitations of the study is, this is the first time the quality chain in System Engineering was referenced to the health policy and management research, the concept of health for the application of the system is still in a relatively junior stage, we hope in the future, or other researchers, can continue to dig this idea deeper in health management areas of application.