The Present Situation Of Basic Public Health Services Of Community Health Center In Changsha

Objective:By appraising the execution of the basic public medical service projects of Kaifu community in Changsha, and the effective cooperation between that and Centers for Disease Control and Prevention, in order to fan out from point to area, the depth advancement to propose policy counteractions accordingly.Methods:Kaifu community in Changsha was selected as the research sample areas, furthermore Dongfeng Road community health service centre and Sifangping community health service centre were extracted from the sample areas as sample agencies. Qualitative research and quantitative research were used in the study.400community residents who accepted public health service were selected by systematic sampling had questionnaire survey. The influencing factors were analyzed by binary logistic regression model or multinomial logistic regression model on the basis of the numbers of response variables. Questionnaire survey was used for staffs of two agencies and conditions of agencies, later we chose Fisher’s Exact Test to analysis the data. On the other hand, we had Qualitative research, which was analyzing the policy, communicating with the leaders, staff and professors to learn the conditions of community health service centre and Centers for Disease Control and Prevention.Results:1. the demographic characteristic of two community health service centre were comparable and showed no significant difference on Gender, age, educational background, professional titles and professional. Health management archiving rate, the aged65years or above residents’ physical examination rate, the aged65years or above residents’health management archiving rate, the reputable health regime rate, all of these in Dongfeng Road community were higher than those in Sifangping community. The full score rate of standard management of patients with hypertension and diabetes in Sifangping community were higher in Dongfeng Road community.2.When elderly patients with chronic are suffering from minor diseases, more than half of them (206cases,51.5%) preferred Community Health Service centers, the patients who choose private clinics, municipal hospitals, third-grade class-A hospitals were67cases (16.75%),92cases (23%) and35cases (8.75%);but patients with severe illness focus on third-grade class-A hospital(238cases,59.5%) and municipal hospitals(162cases,40.5%), no one preferred private clinics or Community Health Service center. χ2test proved that the difference in selecting doctors of different patients’ condition were statistically significant χ2=443.240, P=0.000). The impact of patients behavior in addition to disease itself, but also including employment status, income level, health insurance type, trust understanding status and accessibility of Community Health Service centers and the emphasis on health.when suffering from severe illness, Compared with the municipal hospital, in the post staff (OR=32.379) and retirees (OR=15.173), the monthly income of5,000yuan or more (OR=134.275), rural cooperative medical patients (OR=661.420), highly trust Community Health Service centers (OR=4.231), health indicators measuring frequency in a month to three months (OR=83.927), do not know the telephone numbers of Community Health Service centers (OR=3.017) and the patients who are far from Community Health Service centers (OR=15.704),do not know much about Community Health Service centers (OR=1.619) are more willing to choose third-grade class-A hospital. As for mild patients, compared to the private hospital, primary education level (OR=0.149), retired persons (OR=0.144), patients in higher emphasis on health (OR=0.257) are more likely to preferred Community Health Service centers,while persons in less emphasis on health (OR=10.645) and patients who are far from Community Health Service center(OR=5.217) are more willing to choose a private hospital; compared with the preferred municipal hospital, patients who have medical insurance for urban residents(OR=0.169), higher emphasis on health (OR=0.247), trust Community Health Service center (OR=0.296) are more likely choice for Community Health Service center; compared with third-grade class-A hospital, patients knowing the Community Health Service center’ s position (OR=0.017), telephone (OR=0.148), working hours (OR=0.009), doctors (OR=0.004), work style(OR=0.051) were more willing to preferred community health service centers, aged70to79years and patients farther away from the Community Health Service centers are more likely to choose third-grade class-A hospital.3.Make5as full marks,400patients with chronic diseases where the community health services for treatment environment overall satisfaction average score of4.27points.Patients on overall community health services clinic environment of this investigation is quite satisfactory;400patients with chronic diseases where the community health services for the diagnosis and treatment satisfaction with the overall average score of4.05points. The overall level of patient diagnosis and treatment of this survey of community health services more satisfied.4.Community Health Service centers and Centers for Disease Control and Prevention have teamworks in both Organization and Business development.Conclusions:1.Community health servicesin different areasof construction and developmentin differentsituation,a differentcommunity health servicesin the same area the implementation of basic public health services are also differences2.patient selection for treatment institutions affected by many factors, to achieve the "minor illness in the community, serious illness in the hospital," need Multifaceted efforts such as Propaganda, Improve the technical,fgood planning, Control medical costs and Adjusting Medicare reimbursemen.3.Residents access to basic public health services of are with satisfaction and trust of Community Health Service Center.4.We summary the present situation of teamwork between Community Health Service centers and Centers for Disease Control and Prevention.