Research On The System Guarantee And Promotion Measures Of The Equalization Of Basic Public Health Services In Border Counties Of Yunnan Province

1 Objective:To investigate the current situation and system guarantee of the equalization of basic public health services in border counties of Yunnan Province,and to analyze the system guarantee of the equalization of basic public health services in border counties of Yunnan Province from the perspective of suppliers,and find out the existing problems;to investigate the situation of basic public health services of residents in border counties from the perspective of residents’ health needs;and to put forward suggestions for the special geographical and cultural environment of border counties and measures to equalize basic public health services.2 Subjects and Methods: 2.1 Subjects and methods: The research objects were obtained by multi-stage sampling method.By consulting the relevant documents and materials of geography,economic development,medical and health situation of Yunnan border counties,considering comprehensively the level of economic development,poverty level and transportation convenience,and using the principle of stratified sampling,two counties were randomly selected from the northwest,west,southwest and southeast of Yunnan,and a total of eight border counties were selected as the sample counties in this study.In each sample county,two township health centers were selected according to economic and distance considerations.In each sample county,village health centers were selected according to 20% proportion.According to the principle of systematic sampling,2000 residents aged over 16 years old in the village where the village clinic is located were selected as research subjects to conduct a survey on the basic public health service status of residents.320 persons in charge of health planning bureau,health supervision institute,disease prevention and control center,maternal and child health hospital,traditional Chinese medicine hospital,social health service center(township hospital)and community health service station(village clinic)and other seven types of institutions were selected,and different and targeted questionnaires and interview outlines were designed for investigation.2.2 Research contents: Investigate the basic situation of urban and rural residents(demand side)in Yunnan border counties,the level of understanding of basic public health services,the most common form of contact with residents of border counties in the process of understanding health knowledge,satisfaction of urban and rural residents with basic public health services,the satisfaction of urban and rural residents in publicizing basic public health service policies,and the satisfaction of urban and rural residents in feedback channels;surveying the system guarantees provided by health institutions(suppliers)in border counties of Yunnan Province about the equalization of basic public health services and the defects in the system.2.3 Data processing: 2.3.1 For quantitative data(survey of urban and rural residents: basic information of urban and rural residents(demand side),understanding of basic public health services,the most common form of contact between residents of border counties(in the process of understanding health knowledge),the satisfaction of urban and rural residents with basic public health services,satisfaction of urban and rural residents with basic public health service policy propaganda and satisfaction of urban and rural residents with feedback channels),Epidata 3.02 was used to establish a database and imported into SPSS17.0 software package for statistical processing.Chi-square test and rank sum test were used.2.3.2 For qualitative data(interviews and questionnaires of health institutions),descriptive statistics(survey results of organization and management of basic public health services in Yunnan border counties)and content analysis method(system guarantees of equalization of basic public health services in Yunnan border counties)were used,and qualitative research software Atlas.ti 5.0 was used to collate and analyze the data.Ask the content,extract the effective content,code,classify and simplify the relevant content,and extract the theme.3 Results: 3.1 Survey results of residents’ demand for the equalization of basic public health services.The overall awareness rate of basic public health services was 88.35% for the respondents;1165(59.02%)for “one or two projects” for basic public health service projects;The differences in the understanding of basic public health services among residents of different ages,education,household registration,and average monthly income were statistically significant(P<0.05).There was no statistically significant difference in the understanding of basic public health services among residents of different genders and ethnic groups.(P>0.05).In the process of understanding health knowledge,the most common forms of contact with residents in border counties,the most frequent occurrence of health education materials There were 1491(38.84%);residents’ satisfaction with basic public health services was statistically significant(P<0.001).Residents’ satisfaction with the basic public health service equalization policy: 1096 people(55.52%)are considered to be “general”;Equalization of basic public health services,and channels of feedback from urban and rural residents when they have opinions or suggestions: 833 people(42.20%)are considered to be “basic smoothness”.3.2 Survey results of the management of basic public health service organizations in border counties.54.55% of the personnel in the health administration department of 8 border counties(responsible for the management of basic public health services)indicated that the government attaches great importance to basic public health services,and 100% of the respondents stated that “the local public service project leading group was established”,91.67% The respondents considered that “the local implementation of basic public health implementation plan and fund management plan”,but 33.33% of the respondents ambiguous about the concept of “whether basic public health services are included in government economic and social planning”.91.67% of the respondents believe that “there is a government annual target”,83.33% of the respondents believe that the current household registration system will not hinder the equalization of basic public health services in Yunnan’s border counties;100% of the respondents replied that “standardized health education has been formed System,personnel management system,and health personnel training system”;100% of the respondents believe that “the relevant articles issued by the County Health Planning Bureau are timely to professional institutions”,and 97.06% of the respondents believe that the relevant articles of the County Health and Planning Bureau There is a timely arrival at the Community Health Service Center(township health center);91.67% of the respondents believe that “professional institutions have timely study of new norms”;75% of respondents believe that professional organizations consider “general” for document implementation.3.3 Survey results of problems in the basic public health service equalization system.Qualitative research has extracted five themes:(1)Assessment mechanism: The number of basic public health service assessments is too frequent,which will increase the workload of medical staff.(2)Medical(endowment)insurance system: The proportion of medical insurance reimbursement for urban and rural residents is unbalanced,and the medical insurance system lacks fairness.(3)Construction of basic public health service system: lack of staffing,hardware and software facilities in townships and towns,and low expenditure on funds.(4)Multi-sectoral cooperation mechanism: the awareness of multi-sectoral cooperation in health institutions is insufficient,and multi-sectoral cooperation mechanism has not been established and improved.(5)Information sharing mechanism exists: there are too many information platforms in health system,and the practicability and applicability are poor,and information sharing is not ideal.4 Conclusions: 4.1 The awareness rate of basic public health services of urban and rural residents in Yunnan border counties is 88.35%,but they do not know enough about service items,satisfaction degree of policy propaganda,feedback channels of opinions or suggestions.4.2 There are differences in the understanding of the basic public health service personnel’s emphasis on the government,whether it is included in the government’s economic and social planning,and the implementation of the document system.The number of basic public health service assessments is too frequent,which will increase the workload of medical staff;the proportion of medical insurance reimbursement for urban and rural residents is unbalanced,the medical insurance system lacks fairness;the township staffing,hardware and software facilities are lacking,and the expenditure is low;Health institutions have insufficient awareness of multi-sectoral cooperation,and multi-sectoral cooperation mechanisms have not been established;there are too many health system information platforms,and the practicality and applicability are poor,and information sharing is not ideal.