Research On Activation Policy Of Health Care Of Rural Three-tier Health Care Network In China

ObjectiveThe development of health care in the rural area of our country has got a well future after the policy of equalization of public service providing in rural area has carried out. This thesis is based on the research results from NSFC study of"the policy research for establishing a integrated rural area three-tier health care network"which is presided by professor Zhang, and it's trying to analyze the status of the deficiency of the health care in rural area of our country and seek the causation of these problem, then to make a discussion of perfecting the health care capability for the rural area three-tier health care network in those three points that include government, organization ,and demander and carry out useful policy suggestion for the activation of the health care capability of rural area three-tier health care network by researching the relative theory of basic health care experiences of both our country and foreign countries.Method:This research used the qualitative study as the main method and some quantitative study for supplement to achieve the research objective and route. It has analyzed the problems of health care in rural area and the causation of them by the way of document study, Delphi, and typical case analysis. Document study is about to consult domestic and foreign literature which are about the experiences of the public health and health care in our country and foreign countries, then use relative theory to discuss the development of the health care in rural area of our country; Delphi is about to take a interview on those experts who are engaged in relative regions for years to validate the assumption of the research and get some useful data and policy information; typical case analysis is about to select three places in east ,middle place and west of China.(Shaoxing in Zhejiang province, Xixian in Henan province and Lintao in Gansu province), discover the problem in health care of rural area and validate the assumption of the research by surveying the actuality of health care in those places. Result:This research has got those results: Survey the problem of health care in rural area we could find that there exist disjointedness among government, organization, and demander. Concretely, it include lack of devotion and inadequateness of supervise from the government; lopsided regard between medical treatment and health care from basic health care organization; false perceive from demander. The causation of those problems include:(1)The change of economy system resulted the inapplicability of the traditional health care system in modern society;(2) The government focuses on the economy construction and ignored the public responsibility, it resulted decrease of devotion and inadequateness of supervise.;(3) The malignant competition, timeworn human resource management system, reasonless framework of the organization and service mode have restricted the development of the health care in rural area;(4) complicated factors from demander drives the health care can't be accept widely in rural area.Conclusion:From this research, we can find that we have to reform the government, organization, and demander at the same time to activate the health care capability of rural area three-tier health care network. It means that we should activate the health care system gradually by reform the government, service system, and demander factors as three steps like precondition, measure and assistant. It concretely includes:(1) To compartmentalize the devotion proportion between central government and local government by judging the government's responsibility, and looking for a reasonable supervisor for the health care target in rural area at meanwhile.(2) To make the health care network more reasonable, and promote the benign competition and interaction between medical treatment and health care. To insure a reasonable distribution of the capability during each sector, an advanced management of the human resource, and a well prompting mechanism.(3) To show a positive impression to the inhabitants by health education and well service quality. To connect the health care to some preferential policy to attract the inhabitants participate in health care.(4) To found a channel for information by establishing an information management office which is supposed to be an information collector to provide the evidence for area health care policy establishment.(5) Establishing a health care service provide framework of rural area based on the characteristic of the health care organization, local economy characteristic and demand to compartmentalize different capability of different tier in the three-tier health care network.