Discovery Research On Government Purchasing Community Health Services Position In Jianghan District Of Wuhan City

ObjectivesCommunity health service is the basic of City Health Services System and Community Residents'health doorkeeper. The theories and policies on Government contracting-out—Government reinventing and welfare economics were applied to analysis the feasibility of government purchase community health services. To analysis the feasibility of improving the financial fund use efficiency, contributing to the transformation of government functions and improving Performance through this way. Meanwhile, the number of standard post and investment funds was measured according to relevant standards and the Conditions of JiangHan district. The related practice at home and abroad was summarized to provide ideas and argument for the development of CHS and the health policy making in our country.MethodsLiterature review, quantitative investigation, descriptive analysis, Data envelopment analysis, site surveys and qualitative investigation were conducted. To analysis the personnel system, Performance Appraisal System and investment were studied. The emphasis was to discuss the program of government purchasing community health service positions based on related policies and theory.ContentsThe content of this paper includes: (1) the related theory of government contracting-out;(2) the related practice of government contracting-out;(3) the fundamental condition and related problems of CHS in JiangHan district ;(4) efficiency analysis of CHS in JiangHan district;(5) the fundamental components and key links of government purchasing CHS post;(6) comprehensive approach, Internal working model and evaluation project of government purchasing CHS post.Conclusions1. Welfare economics theory argued that Pareto optimal state need the competitive market mechanism. The measure-government purchase community health services made the community health services payments turn to purchasing health personnel services, it would change the way of financial investment and improve efficiency in of the financial funds.2. One of the important strategies in governmental recreation theory is transforming government functions in order to turn control model government to service model government. Government purchasing community health services would promote to transform government role and make the service provider to turn to purchaser and superintendent.3. The result of literature review shows that whether the measure was to purchasing services or purchasing services post. With the funds, the purpose of the practice at home and abroad was to achieve the quality target of government business not to support the government employees, introduce competition mechanism and improve the efficient of fiscal fund.4. The number of resident population of JiangHan district in the year 2008 was 773, 600. The number of Household population was 460, 900.There were 14 community health service centers in JiangHan district. 11 community health services were financed by the government but self-supporting collective unit. The total number of staff in the post was 1093.The number of health Professionals was 823.in 2008, the annual income of doctors and nurses in community health services in JiangHan district were 15063 yuan and 13978 yuan, ,respectively.5. According to national standards, there were 7.89 posts per million populations should be set up in JiangHan district. Therefore, 610 CHS posts should be purchased. According to township hospital staff Preparation standard of Hubei province, 645 CHS posts should be prepared. The two calculation methods'results were basically the same.6. Resident population to be the service population base, if JiangHan district maintain the amount of financial input as in the year 2008 and purchasing budget per capital was 40, 000 yuan, District Government would increase input 78,907,000 yuan to implement government purchasing Community Health Services posts.7. The pilot work should be carry out in an orderly way. The work includes 6 crucial segments: Setting up a leading group of pilot work, To carry out measurement work, signed responsibility contracts, implement the performance assessment, determining and allocation funds, summarizing the whole work.