Research On The Implementation Strategies Of Equalization Of Public Sanitary Service,Minhang District, Shanghai

Ⅰ. Research Purpose and SignificanceWith the successive issuance of Opinion on Deepening the Medical and Health System Reform by the Central Committee of the Communist Party (Z.F.[2009] No.6) and Notice about Recent Key Implementing Plan for Printing the Medical and Health System Reform by the State Council (G.F.[2009] No.12) in2009, a new round of medical and health reform has been launched that would promote basic public health services have been listed as the recent priorities. Before long, in the Opinions on the Promotion of Gradual Equalization of Basic Public Health Services by the Ministry of Health of P. R. China, Ministry of Finance of P. R. China and National Population and Family Planning Commission of P. R. China (W.F.S.F.[2009] No.70), the working objectives, major tasks, safeguard measures and etc. concerning the gradual equalization of fundamental public sanitary services have been further defined. As one of the three-year prior mission before the new medical reform, the equalization of public sanitary service has drawn the attention from government (the policy-maker and the managing party), professional institutions (the supplier) and various spectrums of the society (the demander) throughout China.Related policies have been implemented quite an amount of time ever since2009. Both the researchers and decision-makers are eagerly concerned about the implementing procedures, emerging effects and obstacles, as well as the potential improvements of the policies. It is also of great significance for their obeying the thoughts of "new medical reform" that embodied by insisting on focusing, digging and arranging the problems that exposed throughout the implement, analyzing and tracing its source and subsequent impact and eventually sorting out political strategies. However, seen from the literature review, most literatures are limited to theoretical derivation and experience description with few empirical studies. Many macro-level studies exist with rather few aiming at the current status of specific implementation, let meaningful analysis of relevant hinders and causes alone. Meanwhile, plenty of countermeasures were proposed in academic reports, but rarely analyses policies formulation scientifically.In this study, investigation will be conducted towards the current status of the equalization implementation of public sanitary service in Minhang District of Shanghai to detect existing difficulties and potential influencing factors. Under the wings of scientific policy formulation, corresponding policies will be proposed, laying a foundation for the studies on public sanitary service equalization in the City of Shanghai and even broader scale.Ⅱ. Materials and ApproachesFirstly, approaches such as the literature system review, intention survey, institution investigation, key insider interview and etc. are employed to initial the study on the current status of equalization of public sanitary services in Minhang District and the whole nation.Secondly, the critical handicap in the fulfilling thee equalization of public sanitary services nationwide will be analyzed deeply and evaluated systematically through literature review. In addition, by taking advantage of system review, intention survey; institution investigation; key insider interview and etc., the pivotal difficulties in the equalization implementation of public sanitary services in Minhang District could be analyzed multi-dimensionally.For good measure, in order to resolve the primary difficulties in public sanitary services equalization in Minhang District, the influencing factors of key difficulties are analyzed through literature reviews, empirical researches and the cause-effect diagram of key problems is drafted with the principle of causality analysis diagram.Last but not the least, by integrating the research results of the above three aspects, policy suggestions for the equalization of basic public health services in Minhang District are proposed by utilizing the policy formulation principles and scientific procedures, and these can be used as the reference for decision-makers and researchers.Ⅲ. Primary research outcome1. Equalization condition1). Generally speaking, the inequality of public sanitary service between city and country, wealthy area to arid area is expanding all over the nation. The "New Medical Reform" endorsed on2009, is therefore expected to be an effective therapy towards that.2). Accounting for the current circumstance of synthetic financing level, resource deployment, service provision and application and health condition etc., the conclusion revealed substantial discrepancies between Minhang and nationwide situation on inequality of public sanitary service. In Minhang, we should shed more light on deeper problems, such as the inequality between service provision and application, supply and demand.2. Crucial impediment confirmation1). Referring to relevant documentation, the insufficiency of government funding, inadaptability of tax collecting system, immaturity of public sanitary service as pertaining to an evaluation mechanism, inexplicit of definitions to basic level sanitary departments and an inadequate number of experienced personnel are the dominating impeding force of public sanitary service equalization of the nation. 2). Through meticulous study and confirmation of relevant articles, concerning the stance of demand, supplement and management, the impediment of public sanitary service equalization is eventually fixed on three sources:1. Low rate of involvement of the residents;2. Immaturity of evaluation mechanism;3. Overwhelmed pressure to paramedics.3. Impacting source analysis1). the essential factors to "low rate of involvement of the residents":low health awareness2.objective singular form of supplement; deficient health insurance;"healthy labor effect"5.lack of social responsibility2). the essential factors to "immaturity of evaluation mechanism":lack of unifies criteria of public sanitary service; lack of normalization testing and evaluation mechanism; the body of testing is retained inside the system.3). the essential factors to "overwhelmed pressure to paramedics":dramatic increment on work quantity and requirement, inadequacy in absolute and comparative human resource; disappointing treatment and incitement strategy.3. Study of implement strategy1. Strategy to "low resident involvement rate":people first, strengthen the ability of activation in public sanitary service, regarding it as both a target and a measure that is counted into final evaluation.2. Strategy to "immaturity of evaluation mechanism":apply routing management, focus more on the processes and improve testing and evaluation mechanism. To be specific, it is important to alter the current condition that overweighs the data and consequence, but pay more heed on human feeling, process and effect.3. Strategy to "overwhelmed pressure to paramedics":clarify the definition and accountability of staffs working at the basic level while enforce specialization inciting plan. Ⅳ. Discussion and Suggestions1. Clarify governmental answerabilityExpediting public sanitary service equalization would contribute significantly on diminishing the gap between areas’ developments, sustaining social security and harmony and distributing accomplishments from reforming, which means a lot politically, economically and socially. However, government’s leadership and answerability should never be overstressed.2. Reinforce practical studyPublic sanitary service equalization has been enforced for over3years, the problem that the policy makers concerned the most is always the effects and difficulty emerged these years. But relevant articles that are derived from most basic level of community public sanitary service departments are extremely rare, which means for staffs who work on such positions, a magnificent of work can be done.3. The restriction of the study and the orientation of further researchDue to the limit of my research capability and work experience, this particular research remains in rough on investigation target and content filtering, data utilization, treatise comments, and policy making procedure. The research design and fulfill are not scrumptious enough. Besides, in terms of the limit of theoretical preparation and research experience, the understanding and study towards macro policy is far from deep and comprehensive. Therefore, this particular research has barely involved with political impediment and other factors that would impact public sanitary service equalization. All in all, further analysis and discussion is expected.