| 1. Research Objectives and SignificanceSocial stability in rural areas means that 69% of population in our country can live and work in peace and contentment. Health status of rural population is the most distinct indicator of health development as well as synthetic national power of our country. About 57.6% of officials insist that rural health shows a more important role for social stability than urban health. Therefore, to our country, the issue how to develop rural health is a strategic stress that cannot slide over. Whereas of this, this research team has been focusing on a series of policy studies on the rural health development since 1985.Based on previous research results of this team and others, it is evident that, compared with urban areas, the rural health development is slower and lags social development in last 20 years. The rural health is more important, more complicated, but it faced more policy transition, turbulence and problems.There exist similar problems like over-increased medical expenditure, disordered pharmaceutical market, critical medical ethics and care quality, low managerial efficiency, overstaffed, and contorted reimbursement mechanism, etc. both in rural and urban health systems. However, these problems seem more serious in rural areas. Otherwise, rural health system also faces its specific problems. For instance, harmonized relationship among three-tier health organizations exists in name only at present, and this relationship has been replaced with vicious competition because of difficult survival circumstances. Managerial and transferred mechanism among three-tier health organizations has disappeared. The township and village levels of health organizations show more obvious chaos while they provide their health care services.If the above-noted problems could not be solved rural health professionals would act blindly in vicious circle, the policy of "prevention first" could not be put into effect, and the policy of "to attach importance to prevention, grass roots and rural areas" would be rested on the paper. However, there exist lots of technologic difficulties and limitations to solve these problems in respects of policy analysis and making as showed in table 1. To remove these technologic difficulties and limitations shaped the research objectives, contents and process of this project.The policy analysis on the Key Issue and Strategies of Rural Health Development in China is designed to aim at determining the key issue, causes and shaped mechanism of key issue, strategies and alternatives to solve key issue by removing these deficiencies of policymaking and researches noted in the table 1.This project was supported by the Natural Science foundation of China (NSFC, 79670059,79925002),Ministry of Sciences and Technologies (K00-10-18) etc.2. Research Methodologies"A Scientific Policy-Making Procedure" established by research team was selected as the supervising research method for this project. "A Macro-Model of Health System" was used to provide the systematic thinking of this research. "The Multi-dimension combined Evaluation Method" was chose to supervise the outline of research contents. At the same times, most of main viewpoints gained from the process of research were demonstrated qualitatively and quantitatively.This research was mainly focused on the middle developed areas in China according to the following reasons: (1) the middle developed areas represent about 80% of counties in China; (2) middle developed means the 5-year-later future of those low developed areas; (3) in general, a policy put in practice successfully in the middle developed areas could be conducted in developed areas easily.Data-collected methods include meta analysis, group discussion, routine statistic data, health service and intention survey, etc. This project surveyed and collected data from 9781 households, 174 villages, 49 townships, 12 counties of 3 provinces in east China based on a random sampling principle. The tests showed that the collected data had acceptab...
|
PDF Full Text Request