Study On Health Resources Adjustment And Countermeasures Research In Tianjin

Objective: The study collected and analyzed of domestic medical resources allocation mode from 2008-2013,combined with the health development of Tianjin,based on the fifth Tianjin health services survey data,Tianjin Statistical Yearbook and the Tianjin health data(2008-2013),the health resources allocation and the utilization of medical services in hospital in recently six years,The study generalized about the concept,the strategy,the thinking and the model of health development with Tianjin’s characteristics,analysis of the health resources for the health service demand,and put forward some suggestions for furthering optimize health resources allocation for the Thirteenth Five-Year Plan,which suitable for the Tianjin government,society,the interests of the individual three aspects of health resources reasonable configuration.Methods : Both quantitative and qualitative method for allocation of health resources in Tianjin were conducted.Data for health resources from institutions was collected,and descriptive analysis method was used in the Tianjin health institutions,health manpower,health beds and equipment,region distribution,the number of health technical personnel’s quality(including age,record of formal schooling and title).Health resources change situation from 2008 to 2013 was described,and also descriptive analysis was performed in the total number of patients,the number of inpatients,and the status of the hospitalized d utilization in medical institutions in Tianjin.Based on the population distribution of health human resource,the Lorenz curve was used to the evaluate the fairness of health resource,and the balance of health human resources was evaluated with health density index;By the fifth national health services survey and household health interview was conducted to understand the residents’ health services needs and demands,potential demand and utilization;Panel discussion method to put forward some suggestions about perfection of medical services in hospital and reasonable allocation of medical resources.Results:(1)By the end of 2013,there were the total increase of 1912 medical and health institutions at various levels in Tianjin,of which including 85 hospitals,1826 grassroots medical institutions and 9 major public health institutions;the number of health facilities were on the rise in general;Percentage of Private hospital increase more than public hospitals,which is 52.9%,public hospitals is 157,a 4 increase over2008,Private hospitals,176,a 108 increase over 2008,under the guidance of national policy the proportion of private health institutions is gradually increased.(2)At the end of 2013,the city’s total number of health workers reached 10.7 million,an increase of about 2.1 million more than in 2008,the health workers in health workers reached 8.1 million,an increase of nearly 1.6 million people,including practicing(assistant)doctors)32000,an increase of nearly 0.6 million registered nurses 30,000,an increase of nearly 0.8 million people.(3)The total number of beds in medical institutions continued to increase,by the end of 2013,the city’s medical institutions amounted to 58,000 beds.Compared with the end of 2008,12,000 beds increase,the number of beds per thousand medical institutions rose from 4.65 to 5.74.(4)medical services.The city medical services continued to grow,the number of clinics were exceeded one hundred million people,the masses medical treatment difficulties get some relief.Outpatient and inpatient workload.In 2013,the city’s medical institutions amounted to 105 257 000 Total Visits passengers,hospital63,056,000 passengers(60.0%,primary health care institutions 39,557,000passengers(37.6%),other medical institutions 2.644 million people(2.4%).2008 Visits to the city’s 52.079 million passengers,hospital 29,308,000 passengers(56.3%),primary health care institutions 12.32 million people(23.7%)compared with 2008,the hospital clinic visits increased 33.748 million passengers,primary care clinics and health institutions 37,237,000 passengers increased passengers.(5)Hospital physician workload.In 2013,the hospital physician responsible for daily clinic visits and hospitalizations 1.9 and 11.8/day,of which: public hospital physicians responsible for daily clinic visits and hospitalization 11.5 and 2.0 / day.Compared with 2008,hospital physicians daily workload increases.(6)The use of hospital beds.In 2013,the city’s hospital bed occupancy rate is 84.8%,of which: 89.9% of public hospitals.Compared with the previous year,due to increased number of beds,hospital bed occupancy rate has decreased,people hospitalized difficult eased,but tertiary hospital inpatient pressure is still relatively large,bed occupancy rate is close to 100%.In 2013,the hospital discharged an average length of stay was 11.2 days,which: Public hospital 11.3 days.Compared with 2008 year,the average hospital length of stay 0.8 days lengthen;but shortened0.2 days in public hospitals.(7)The Situation of Infectious Disease Control: The incidence of A and B infectious diseases rate continues to decline,which was dropped from253.25/100 thousand People to 149.06/10 100 thousand People.(8)The infant mortality rate: In 2013,the infant mortality rate was 4.94%,of which: 4.81% City,5.14% rural;0.26 percentage points lower than in 2008.(9)The maternal mortality rate: The maternal mortality rate slightly improved,increased from 7.26 in 2008 to 8.77 in 2013,increased by 1.51 Percentage points.control in the 10/10 million or less,to keep in the forefront of the country,reach the level of developed countries.(10)The Average Life Expectancy of the Residents.The average life expectancy of the residents in Tianjin was81.20,compared to 2008 increased by 1.41 years.(11)The fifth National Health Services Survey Preliminary results show that: the city’s residents 46.6% prevalence of chronic diseases,and has greatly improved over the last survey;where 24.77% prevalence of hypertension,diabetes and 7.93%.Two weeks prevalence of 36.22%,17.41% attendance rate two weeks.The survey also initial indications: the treatment of choice for residents of the county hospital above the county(secondary and above)hospitals,more than 93% the proportion of outpatient primary health institutions showing the proportion of gradually increasing trend.Conclusion:The total amount of health resources in Tianjin rich and increase year by year,the percapita share of health resources also showed an increasing trend,but with Beijing,Shanghai and other places relatively still relatively low,there are still gaps and rural resource allocation,the use of the grass-roots health institutions beds rate is not high;still the most important factor in chronic health hazards;residents have increased the demand for outpatient and inpatient medical services,health resource allocation also put forward higher requirements.Should continue to establish a demand-driven mechanism to optimize the allocation of health resources,accelerate and optimize health resources and incremental pace of inventory adjustments and improve the effectiveness and fairness of the allocation of health resources utilization,and increase government investment,especially to strengthen personnel strength training,the construction of high-quality health personnel.