Study On Present Situation And Developmental Strategies On Private Medical Facilities In Rural Tertiary Health Services Network

ObjectiveThrough in-depth study on present situation of rural private medical facilities, their extant problems as well as their roles were defined. This paper also analyzed the developmental concepts of rural private medical facilities rationally; summarized the experiences of how private medical facilities and public medical facilities could cooperate with each other well, with which, the private medical facilities could played their should-be parts, and illustrated the government's responsibility for developing rural private medical facilities. Under the environment of national health policy, this paper summarized the reform experiences in different areas, explored developmental orientation and strategies of rural medical services system and defined the functioning position of private health post.Methods1.Literature review: Many domestic and oversea literatures related to rural health and private medical facilities were researched.2. Regular analytical Method: The theories of Policy Science, Economics, Management Science, Social Ethics, Politics and other Sciences were utilized to conduct logical deduction of the materials in this research.3. Field trip: Relative data were collected in three counties by use of questionnaires and in-depth interview.4. Experts discussion: Repetitive interview and strict discussion were conducted basing on previous researching results and some researching methods, and relative experts in Health Management Institute participated in the discussion.5.Statistical Analysis: Epidata was used to input the data and descriptive analytical was conducted by means of Excel2003.Results1. Rural people's utilization of health services and the proportion of choosing private medical facilities were defined.The investigatory outcome from three areas respectively in the Eastern, Middle, Western parts of China showed, more than 70% of patients in the Middle and Western areas utilized services provided by private medical facilities.2. Functions of the private medical facilities that were not completely performed, as well as the reasons were illustrated.The cooperation between private and public medical facilities was lack, and the problem of mechanism bias in private medical facilities was projected. As the private and public medical facilities had no cooperation, it led to no integration of their functions. Private medical facilities established different kinds of mechanisms basing on their profit-oriented goal, and over passed public health services functions, all of which affected the comprehensive functions of the rural health services network.3. The number of private medical facilities in different tiers of rural health network was definedIn rural health posts, private medical facilities constituted more than 80%, and in some Western areas, this proportion reached nearly 100%. In the county level of hospitals, the proportion of private medical facilities didn't exceed 10%, and in the township level, this proportion didn't exceeded 1%.Conclusion1. Private medical facilities in different levels of the health network played different roles.Private medical facilities in county and township levels played roles in supplementing health services, promoting competition and activating market; private medical facilities in village level played role in supplementing the inadequacy of health resources and filling the vacancy of the health services system. 2. The major problems of private medical facilities lied in township and village levels, especially the village levelIn the county and township levels, public medical facilities were the major players, among which, competition lacked. However, in the village level, there were many private facilities, which stimulated to produce irregular competition because of their pursing after economical benefits.3. In the village level, private medical facilities faced some instable factors, which had impact on rural health services network providing health services and also prevented it from performing functions.4. Private medical facilities had functioning flaws, which mainly lied in wrong orientation of health services provision and low services quality. Meanwhile, township hospitals didn't conduct scientific management targeting at health posts.5. In the future, the public and private medial facilities will co-exist in the village level of health services system. The imperative is to assess the present situation of health posts and adopt different developmental strategies targeting at health posts with different developmental conditions.6. Major policy recommendations and suggestions for the benign development of rural private medical facilities.(1) Improve relative laws, regulations and policy documents for private medical facilities.(2) Propose including some private medical facilities in the network of designating facilities of NCMS.(3) Take different kinds of measures to enhance capacity building of rural health posts.(4) The government should assume its responsibility for improving the ability of private medical facilities in providing comprehensive health services.