Study On Development Status Of Private Community Health Service Organizations In China

Research PurposesCommunity health service as the base of urban health care system in China is the mostimportant access to enhance the implementation of reform on the urban system. Communityhealth service in China has developed remarkably under the promotion of central governmentsince 1997, but the quality and speed of its development is still much more below than theexpectation of the society. One reason which could be applied to explore it is that there havebeen still some uncertainties concerning its key policy issues on systematical framework oncommunity health service organizations. Or the problem could be concluded as whom among theprivate or public organizations can provide community health service much better concerningfunction, quality, respect to community public benefit, and efficiency? Could the private sectorsplay a leading role in promoting community service development in China?Just as the new health reform has started recently in China, to find the essential charactersof private community health service organizations through a well-designed comprehensive andsystematic study, which is based on its performance to public well-being, would facilitate policyimprovement and implementation on community health service development in China.This study on private community health service organizations in the key 28 cities selectedby the Ministry of Health is an in-depth analysis. It includes the basic infrastructure, equipment,policy implementation, financial revenues and expenditures, human resources, service provisionand relative efficiency of service provision compared to community health service agencies runby public or enterprises. Except comparing according to the distribution of private communityhealth agencies in eastern, central and western part of China which is aimed to explore thedifference in development process across region, some in-depth interviews with experts,government officers, health professionals, individuals who run private community healthorganization as well as community residents and field investigation to some private communityhealth service organizations have also been carried out. It is great significance that the currentdevelopment status of private community service organizations in China and its essential characters have emerged through the research which would provides a solid foundation in theoryand methodology for formulating relevant policies for the future development of communityhealth service in China.Research MethodsIn this study, the literature review, field investigation, experts discussion, the descriptiveanalysis and hypothesis testing methods were used. In data analysis and processing, we haveused statistical description, chi-square test and DEA methods.Research ContentsFor evaluation on the development status of private community health serviceorganizations, this study has focused on important aspect of all community health serviceorganizations in the key 28 cities. It included: (1) infrastructures status and implementation ofrelevant policies of the investigated private community health service organizations, in order toexplore the internal and external environment; (2) the financial revenues and expenditures:including revenues, expenditures and the balance of payments; (3) human resources: thecomposition of qualifications, titles, professions and personnel training; (4)service provision:mainly included prevention, health care, medical care, family planning, rehabilitation, andhealth education.; (5) the relative efficiency of services: mainly focused on the key cities.Research ResultsThe study has shown that private community health service organizations had some effecton making up for the lack of health resources, promoting the establishment of communityhealth services organizations, facilitating patients to get medical treatment at community as wellas had some influence on reform of public community health service facilities. The study hasalso shown some challenges to private community health service organizations: (1) It isdifficult for it to make clinical decision primarily according to the benefit of client, for instance,induced utilization on drugs and mainline are too often to be observed; (2) It is hard for it toimplement qualified public health intervenes due to difference on quantity of compensation frompublic finance; (3) It is hard sometime for it to provide equal qualified service infrastructure for its clients compared to other communities in the same city; (4) Sometime it is too often of aprivate community health service agency closes its operation in a community due to transfer itsfund to other issue. (5) It is not unusual that the internal management is poor and not wellregulated in some private community health service organizations, for instance, though theservice efficiency of the private community health service centers in 77.78 percent of the keycities are DEA effective relatively, while the private community health service stations wereDEA effective relatively in only 22.73 percent of the key cities; (6) There are some weakness onexterior surveillance as well as in policy implementation which is designed to help the service.People can easily make their own judgment on the essential character of private communityhealth service organizations at current period in China due to the information provided by theresearch.Policy suggestionsIn view of the evaluation results, this study proposed the following policyrecommendations: (1) Community health service organizations run by public should play theleading role in community health development in China in order to protect the benefit of publiceven from the systematical framework aspect. (2) The Government should strengthensupervision and management for private community health service organizations; (3) Privatecommunity health service organizations should focus on improvement of its internalmanagement, especially focused on quality of medical care services as well as honesty to itsclient; (4)The government should direct and help private community health service organizationsin providing public health and medical care service properly, especially through implementingrelevant policy supporting that includes policy of finance, policy of price control, policy ofrevenue, policy of social medical insurance, policy of health service administration, etc. (5)The government should pay much more attention on promoting the development of the wholecommunity health service system in the country, especially helping the central and western partof China, enhancing the reform of operational mechanism as well as improving training forcommunity health professionals. The innovation of the study1. We conducted a comprehensive, systematic, objective and in-depth research about thedevelopment of PCHS institutions for the first time.2. We compared PCHS and the CHS that belong to government or the affiliated medicalinstitutions and enterprises firstly, in order to disclose the main strengths and weaknesses ofPCHS.The limitations and the further study suggestions1. As a result of restrictions on raw data, we failed to conduct the analysis about thecommunity health service quality and user satisfaction, which will be the subject of researchfocus of the next step.2. Due to the shorter time span of the database, we could not make a vertical comparison bydifferent years.