| The health enterprise is the important component of the society development. The health service system is the base of health enterprise and its sustainable development is the important guarantee and component of the economy and society sustainable development. Since Chongqing's direct jurisdiction, its economy has been developing and people's living standard and health demand have been rising quickly. The contradiction in health enterprise has emerged and has restricted its development. In this study we summarized the development of health enterprise since Chongqing's direct jurisdiction, analyzed the predominance and deficiency of it and established macro system dynamic (SD) model of Chongqing's health service system. Based on the SD model, we made a series simulation experiments to analysis the dynamic behavior and internal mechanism of the system and to evaluate the sustainable development ability of Chongqing's health enterprise. With the study results, we proposed a series policy suggestions to improve the development of the system and provided credible data support aimed at optimizing the health resources allocation. At the same time, we made some methodological exploration with the SD model first used in the study on sustainable development of health service system and extended the methods on the study.The data used in this study included conventional statistical data including Health Statistical Data Collection of Chonging during 1997-2006, Statistical Yearbook of Chongqing during 1998-2007, Health Statistical Yearbook of China, and the data announced on the website of National Bureau of Statistics (http://www.stats.gov.cn/tjsj/ndsj/); special investigation data including the data of investigation of health service in 1998 and 2003, the data of the total health expenditure (THE) in Chongqing during 1997-2003 and 2005, the report of society development synthetic evaluation study in Chongqing in 2004, the data of survey of new rural cooperative medical system family health inquiry of Chongqing in 2005, and some other data and information such as health policies, monographs, literatures etc. The methods used in this study included qualitative and quantitative methods. We used descriptive statistics and econometrics model (such as Gini coefficient, Lorenz curve, Theil index and Data Envelop Analysis) to analyzed the natural and economical situation in Chongqing, the health service need and demand of people, health resources supply and utilization. We also used SD methods, system thinking, expert consultation, regression analysis, statistical prediction and econometrics model to established the SD model of Chongqing's health service system sustainable development, and then we used the model by simulating runs. At last, we used the methods of systematical analysis, literature concluding, expert consultation and SD methods to made a series of policy intervention experiments to evaluate the effect of the model.The main results of this study included:1. The chronic non-infectious diseases have been the main causations harming people's health. The change of disease spectrum and population aging bring the increase of health service need and demand. The health service need and demand in rural are more than those in urban. The too fast growth of medical care expenditure has been one of the severest obstacles preventing people, especially people in rural, from using the health service. The demand of public health has been increased. The problem of infectious diseases has been still serious because some infectious diseases which had been controlled revive. Especially, the prevention of AIDS has been very urgent.2. At present, the medical service system of urban and rural, public health service system and medical security system have been established which are accordant with the development of social economy. However, to speak with the allocation and utilization of health resources, there are lots of problems such as the low total quantity and quality of health resources, the low equity and utility efficiency, the unreasonable structure of THE financing, the low level of the government investment, the imbalance of the development among health service institutions, the too fast growth of medical expenditure, the low coverage and level of medical security etc, which are seriously obstructing the development of health enterprise.3. In the study we established SD model which had 114 variables and equations, and the effect of it was passable. The results showed that the main cause of Chongqing health service system were the low government investment and the unreasonable allocation of it, which brought the imbalance of the development among health service institutions and aim dislocation. According to current status, the increasing tendency of the percentage of personal health expenditure to THE would be controlled, but still high. The problem of high medical expenditure paid by people would not be solved radically. The maternal and child health status would be better, but the infectious diseases status would still austere. The health human resources would be optimized but still far from the national criterion. The structural illogicality would be improved but still serious.4. In our study three policy intervention experiments were conducted under different government investment increase and different distribution projects. The results showed that with the precondition of THE's benign increase, government health expenditure would increase 80%~100%, the priority would be given to health service system development, and the urban medical service system would be controlled properly. The distribution proportion of increased government investment to public service system, urban medical system and rural health service system might be 1.8:1.2:3:4. With the forgoing framework, the problem exposed during sustain development of health service system in Chongqing would be greatly improved.Policy suggestion: The target should be located on preferential guarantee of people's basic medical need. The emphases of policy intervention should firstly be public health service. Secondly, the medical resources should be allocated on the basic clinical services with low cost and high efficiency. Thirdly, those clinical services with good treatment effect but high cost should be developed restrainedly. Fourthly, those clinical services with bad effect and thigh cost should be given up. Fifthly, more attention should be put into the improvement of medical technique. The government function should be strong in the sustainable development of health service system, which means to strong the ability of government financing and distribution and to make comprehensive intervention on the constructing and development of health service system. The policy framework in the future is to establish a medical service system covering all people with no limit between urban and rural, to increase the government investment on public health and basic medical institutions, to increase the coverage and level of medical security system and to separate pharmacy from medical service.
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