Workload Of Public Health Service In Community Health Service Institution In Tanggu,Tianjin

Objective: By investigating the workload of the primary public health service carried out by 10 community health service centers in Binhai new area and Tanggu District of Tianjin, we aim to explore the work measurement method synthesizing the ease of work, employment risks, physical output, consumption of brains and mental pressure. Additionally, we expect to offer suggestions for the performance and human resource allocation of primary public health service.Method: To measure the primary public health service workload in primary public health service institutions in a more appropriate way, we integrate the ease of work, employment risks, physical output, consumption of brains and mental pressure on the basis of work time dimension into final measurement. First, public heath services were divided into multiple units of work according to work contents and actual situation by expert interview method; the units were classified into six classes.Second, to investigate and analyze the workload of public health services. The number of copies and unit work time of public health services, and the basic situation of community were investigated in the round 1. In the round 2, to correct the unit work time and the respondents were asked to grade the difficult degree, risks,physical consumption, mental consumption, and stress of each work unit. Lastly,calculate equivalent coefficient and workload. The influence of these five dimensions to workload and weight index of each dimension were determined according the result of expert interview. Selected “hypertension-physical examination” as standard,calculated the intensity index of each dimension after standardizing, we could make equivalent coefficient by multiplying weight index and intensity index together, and then calculated the total workload of public heath services.Result:(1) The results of work time dimension indicated that the total work timeof monitoring and investigation is the longest, followed by information management,diseases(health) management and physical examination. And the total work time of assistance is shortest. Among the 11 classes public health service projects, the management of the elderly has the largest share of work time while the management of disabled people, severe mental illness and stoke have the least share.(2)Equivalent coefficient is divided into five dimensions: difficult degree, risks, physical consumption, mental consumption, and stress, the weights of which are 0.4273,0.1450, 0.2818, 0.0648 and 0.0908 respectively by expert interview. The intensity scores of five dimensions showed that the intensity index of the“hypertension-physical examination” is 1 by standardizing. In terms of unit of work,the highest equivalent coefficients are the neonatal visiting(1.2970) and visiting of neonates who are at high risk(1.3112).(3) Xiangyang Community shouldered the largest workload among those community health service centers because of high proportion of Child Health Care, while the workload of Management of the Elderly and Child Health Care accounted for the largest proportion of that of the 11 classes’ public health service projects. There was no significant relativity between the workload of each public health services and resident population or the number of institutional service personnel. Sanhuailu Community had larger population of residents and institutional service personnel; however, it had a lower workload during2013 and 2014.Conclusion: The data of this study is from the actual work, referring to the related researches on nurses and doctors. The formulas introduced in this article was sample and applicable for measuring the workload of public health services and useful for community health service institutions with respect to performance appraisal and human resource allocation. The results suggest that there is no obvious connection between total workload of primary public health service in different communities and resident population, so the reference value supported by primary public health service basing on the resident population is unreasonable.