Well, General Type, Basic In Towns And Townships

ObjectivesThe "Eleventh Five-year" national technology supported key project-"Technology demonstration and product development in different types of township health centers"-aims at solving key problems in constructions of THCs (township health centers) and improving the service capability of them through three types of model construction. Relying on the subproject "Research on Key Technology and System Integration of Information Construction in Township Health Centers ", we explored the principles, criterias and methods of classification of THCs and sought for the basis of classification. Based on in-depth study of current situations of THCs, we summarized the characteristics on scale of constructions and service functions. We also studied on the configuration standards of buildings, departments, equipments and staffs, e.t.c. We hope that it can provide scientific basis for management and guidance of classification.Methods:1. Literature review:The relevant policy documents and research data published in the past10years were obtained by searching tools. We conducted a comprehensive understanding about the classification situation of the THCs.2. Field investigation:Collect the relevant data in the scale of construction and service functions of township hospitals in the field.3. Two-step cluster analysis:Twostep cluster analysis was used in the classification of township health center samples. Test the consistency between demonstration centers and clustered centers. Explore the classification criteria of different types of THCs.Seek for the scientific basis of "Well-off’,"General" and "Basic" classification.4. Statistical description and statistical inference:Describe the current status of township health centers’staffs, beds and department distributions, summarize the construction scales and service function features of "Well-off,"General" and "Basic" type THCs.5. Normative analysis:Taking the national average or requirements from policy documents as a standard, we analysed the gap among "Well-off","General" and "Basic" THCs. We studied on the gap between characteristic index and the standard ones in THCs, looking for what is needed to be improved in the index of constructions.Results:1. Summary of classifications:From what literature has shown, we found that the classification standards was mainly in accordance with the difference of service functions, number of beds, geographical locations, township population, economic level and comprehensive scoring, e.t.c. Summing up all the current classification standards of our country, we draw two main methods: classify by service function or classify by economies of scale.2. Discuss on the basis of classifications:The results of consistency examination have shown that economy of scale is the most important basis to decide whether or not a THC is of "Well-off" type, service function is the most important basis to decide whether or not a THC if of "General" type or of Basic"type.3. Summary of demonstration THCs’ configuration standards:From the perspective of allocation of resources such as staffs, construction area, beds and equipments, the order from high to low is:Well-off>General>Basic. From the perspective of ability to raise funds,the order from high to low is:Well-off>General>Basic.From the perspective of service functions, Well-off type THCs could provide greater medical sevice, six functions in unity(prevention, health care, medical care, rehabilitation, health education and family planning technical guidance) are fully played. General type THCs can provide more comprehensive functions of sevice, basic health care and public health services can be guaranteed. Basic type THCs’ characteristic is decribed as small size, fewer facilities (staffs, beds and equipments), minor area, weak ability of providing basic medical services and public health services.4. Normative analysis:Well-off type and General type THCs have better allocation of resources such as staffs, beds and equipments. They have higher level in the index of construction area, number of doctors per thousand people, number of beds per thousand people, value of expensive apparatus than that of the standard. On the contrary, the same indexes of Basic type THCs do not reach the standard level yet.5. Charicterastic summary of Well-off, General and Basic type THCs:Well-off type THCs usually locate in the towns that have convenient transportation and large population.Their service covers a certain area. Large scale, good facilities and complete department settings makes them win the advantage in some diagnosis and treatment of diseases. Besides, they make more contributions to the aspects of chronic disease control, preventive health care, maternal and early childhood health care, e.t.c.. General type THCs usually locate in towns of medium economic levels. They have a little advantage in the configuration of staffs, beds and equipments than the national average. Their service covers a certain area. In the perspective of service functions,they can provide both basic medical and public health care. They can carry out a comprehensive service such as common disease treatment, chronic disease management, preventive health care, maternal and early childhood health care e.t.c.. Basic type THCs are located in poor region and serve less people. They do not have sufficient staffs, beds, area and equipments. Their service capacity in basic medical and public health care is weak.Especially they are lack of the ability to diagnose and treat specialized diseases.