Study On The Division And Cooperation Betweendistrict Level Preventive Health Care And Community Health Service Agencies

BackgroundWith the deepening of the reform of medical care system, Governments at all levels use of community health service as a role of the bottom of the net, To provide the equal access to basic public health services to the urban and rural residents directly. In order to promote the effective implementation of the service, The country put forward to build the new city health service system Which is based on community health services,and has reasonable division and close cooperation with prevention health care. However, due to the system and mechanism which have been formed for a long time in our country, and the deficiencies of the community health service itself. here are many difficulties and obstacles in the establishment of the system. Therefore, To explore how to establish the effective cooperation between preventive health care and community health service agencies has the important practical significance toromote the urban and rural residents to enjoy equal access to basic public health service.ObjectivesThis study aims to survey the current situation of the public health service which is undertaked by prevent health care and the community health service institutions; Find out a series of the crux of the problem of bad relationship, inaccurate function orientation, not clear responsibility between preventive health care and community health service agencies prevention and health institutions and community health services, and put forward a constructive suggestion.MethodsTo clear the direction of the study and prepare questionnaire through the review of the literature; In the research of situation of the basic public health services capacity of thecommunity health service, all the community health service in12area county was investigated; In the research of division and cooperation relations between preventive health care and community health services agencies, all the district level the institution of disease prevention and control and maternal and child care centers were extracted,and12community health services agencies were extracted in12district and county in QingDao,and orgnaization controller and staff were extracted randomly; In the research of the project effect which was completed by community health services,12community health services agencies were scord according to the evaluation index,and service object were extracted randomly to for satisfaction and awareness survey.Main ResultsIn the research of situation of the basic public health services capacity of the community health service agencies, we fined that the education background and the title level of the community health service agencies is generally low, In staffing,30.5%of the agency equipped with general practitioners,32.1%had public health doctors,32.9%have women care doctor,35.8%have a children’s care doctor; Preventive care department is insufficient, Open vaccination room accounted for18.9%, children’s health accounted for19.3%; In equipment, the community health service agencies which10kinds of preventive health care equipments were full equipped only7.0%,4kinds of health education equipment were full equipped only25.1%. In the research of division and cooperation relations between preventive health care and community health services agencies, we fined that Only four of institution of disease prevention and control and three women and children organizations take technical guidance into annual plan and manage regularity management; The institution of disease prevention and control has65.3%, maternity and child care centers has68.1%person think that the cooperation relationship is not smooth; Information communication is not smooth too, the institution of disease prevention and control has90.3%, maternity and child care centers has91.7%and the community health service agencies has87.9%person think that the information communication mechanism is not sound, the technology support of the preventive health care has significant correlation with the performance of project in community The number of training and frequency, the number of technical guidance, information system establishment, clear division of work and so on, have significant positive correlation with community health service agency service project score, residents satisfaction, residents service awareness,and the awareness of knowledge about health (p<0.01或0.05)Conclusions and suggestionsThis study think through the investigation and analysis:Community health service service ability is insufficient which restricted the sinks of the service function, so that the the establishment of the division and cooperation relations is lack of foundation; not clear duties,and lack of business fund support in the preventive health care and impeded information communication,is the main reason causing cooperation not thorough and the technical guidance lag, which restricted the preventive health care institutions to conduct quality control to basic public health service project; Strengthen business training and technical guidance to the community health services, clear responsibilities and establish information communication system is the important influence factors to establish division and cooperation mechanism. Therefore, it puts forward the Suggestions based on the conclusion:1.To further strengthen the general practitioner training and increasing investment further up and enrich professionals and equipment of the community health service.2.Give play to national, provincial, municipal preventive health care function to guidance the project work of the Local and grassroots, Straighten out the basic public health service project management system in all levels of the country, province, city, district (county),give play to the technical advantage of the preventive health care institutions and use of community health service as a role of the bottom of the net.3. Strengthening the responsibilities of precaution health care in the basic public health service project,through the administrative intervention and take it into the assessment scope of basic public health service project, and at the same time,guarantee business funds to firing enthusiasm of grassroots preventive care institutions.4.Establish basic public health service business training and technical guidance system, Clear and definite the time and frequency of technical guidance and take it into the routine work management; Set up information report system, inorder to make preventive health care understand the progress of community service projects easily for quality control.