The Development Of The Community Health Service From The Perspective Of The Publics Ervice

The community health service provides an integrated service which is community-oriented, based on families and focusing on individuals. It is a stratigic measurement to develop the community health service in China's health reform and development, it is also a major way to solve the difficulties, complication and high cost of getting medical treatment for people , and a concrete method in carrying out the scientific concept of development. China is now in the critical stage of the community health service development, many cities have carried out beneficial explorations and practices, but in terms of the entire country, no strict logical theory models have taken into shape and no operating patterns can be followed in this field.In 2005, Songjiang district was declared as an experimental unit of the"Joint reform in medical service, medical insurance and medicines provision(three Ms)"by the Shanghai Municipal Party Committee and Shanghai Municipal Govenment. In the reform practice of more than one year, Songjiang government took the community health service reform as the starting and breakthrough point of the"joint three Ms reform", strengthened the government's responsiblities and carried out pratical explorations in mechanism and system of the community health service.In order to summarize the experiences on the theory level, from the perspective of public service theory, this paper analyzed the case of the the community health service reform of Songjiang district, the current progress and existing problems, and came up with the countermeasures to handle the problems at the end. Through the case study, this paper aimed at finding out the obstacles that restricted the development of the community health service of our country and the system factors (namely the government factors) behind these obstacles, then discussed the role of the government in the development of the community health service and put forward proposals on policies to promote the development of the community service. This paper believed that with the typical case study and theory analysis, it is more accurate to decide the role of the government in the community health service, and it also provided the suggestions for policies to solve the deep-rooted confliction in community heath service.This paper is composed of four parts.First part: briefly analyzed the evolutive history of public service theory, the connotation and characteristics of the public serive in theory, elabrated the types of the public service of the government, compared the features of different countries'public service modes, considered the direction of the China's public service development mode. In Brief, on current stage of our country, government should allocate more material and financial resources to social public service and assume more responsiblities which they are supposed to carry. As for the health sectors, government should take its responsibilities in community service which integrates public health service and basic medical service and represents public welfare.Second part: based on elaborating the meaning and content of the community health service, comparing with the experiences of the developed countries, reviewed current modes of the community health service of our country, pointed out the existed problems such as insufficient investment from the government and relatively low status of community doctors. This paper further analyzed the function of community health service as part of the social public service, that is, government is the builer, orgnizer and governor of the community health service. It is the key of the community health service development that government attaches more importance to it and provides more investment.Third part: as a experimental unit of Shanghai's"joint movement of three Ms reform", Songjiang has took the community health service as the cut-in point of the"joint movement of three Ms reform"in more than one year's reform, increased the government investment, improved the regional planning, transformed the operating mechanism of the community health service, improved the patterns of General Practitioners group service, promoted the integrated management of towns and villages.Forth part: the key of this paper was to point out some achievements obtained in the current community service reform of Songjiang district on the basis of theory analyse and case study, this paper analyzed the existing problems and gave some advices to the improvement of the community service of Songjiang district. In Songjiang, the government should support the community service reform actively, further improve the regional planning, continously integrate the medical resources, give great support to the the community service on the aspects of medical techniques, information, laboratory etc., vigorously train General Pratitioners and strengthen the construction of the troops of village doctor.To make this reserch more practical, some reserch measures have been mainly adopted in this paper: first, the combination of theory study and demonstration analyse, second, using comparison method, the patterns of public service and the community service in both home and abroad were compared and their advantages and disadvantages were analysed, third, using case study.