Study On Provision Model Of Rural Public Health Service Package

Traditionally, the provision model of rural public health services was directly produced and provided by government. However, with the establishment and development of the socialist market economy, this service provision model had not fully satisfy the change in demand for public health services of rural residents, and revealed its own existence of deficiencies and inadequate. Through the theoretical and empirical analysis on the provision model of rural public health service packages, this dissertation had explored the combination of government and marketing advantages in the provision of rural public health service and built a new provision model of rural public health service packages, thus constantly improving the quality and efficiency in providing the rural public health services.Methods1. Literature reviewMainly selecting databases such as the Pubmed, Proquest, Medline, CNKI and Chongqing VIP, Wanfang database, newspapers and periodicals copying database of RUC, collected the relevant literatures at home and abroad (books, periodical articles, investigating reports, government reports and documents) and built literature database. Through review these relevant literatures, systematically looked into the evolution and development trend of rural public health services system, summarized relevant studies and research experience on public health service packages. Selectively studying the social system and rural public health system, the designing and establishing of service package items, financing, compensation and paying, regulation in the provision of public health service packages.2. Delphi techniqueAccording the chosen principles, chose experts and scholars from the public administration and public health and other related areas in research institutions and government departments and obtained the specialist guidance through semi-structured interviews. Particularly obtained guidance on the selection of rural public health service items that systemized from literatures and suggestions on the problems faced in the pilot running of provision model.3. Focus group discussionIn process of building the provision model of rural public health care packages, setting topics to technology problems such as costs calculation and payment and key links such as performance management and establishing monitoring mechanism, organizing relevant experts and scholars to discuss to optimize the operational process.Contents1. From the macro view of reform rural medical and health care system, combined the rural economic and social development trend, constructed theoretical framework of rural public health service packaged provision in China according practical operational performance of the service provision model based on the design framework of provision model of rural public health service packages.2. Analyzed relevant theories about service package providing including service purchasing and performance management using theoretical research method based on the deep-analysis on provision nature of the rural public health service packages. And further defined the specific screening method of service items, the costs measuring ways and the operational process of service packages.3. Based on the systematic theoretical analysis and research, indentified the proper provision model of rural public health service packages, analyzed the operational process of service packages including screening service items, service packages purchasing and paying and supervision and proposed the corresponding improvement measures and policies to enhance and improve the rural public health services providing system. Results1. Establishment of conceptual and theoretical framework of rural public health service packages. Theoretical research on the provision of rural public health service packages in China had over centered on the research of the overall framework or the provision of basic community public health service packages and study on the provision model of rural public health service packages was relative scarce. This research had preliminarily established the conceptual and theoretical framework of rural public health service packages based on the definition of relevant connotation and systematical summary and analysis of relevant basic theory.2. Selection of the provide mode and establishment of operational process of the rural public health service packages. Based on the analysis and research of the relevant theory, and further define the special properties of public health service and the leadership responsibility of government in public health services provide, combination of diagnostic analysis of provider mode of traditional service and the basis of provide model of rural public health services package, propose the appropriate mode to provide the rural public health services packages by government purchasing, in order to improve quality and efficiency of service. On this basis, analysis and discovery the operation process of provide mode, and form the operational process of provide of the rural public health care packages.3. Based on the principles and procedures of rural public health service, based the state's basic sanitation services, combined regional social and economic development and expert opinions interviews, the study preliminary established the list of rural basic public services, including 14 basic public health services packages and 103 basic public health services, and define the content of service and implementation.4. Study on the provision instruments of rural public health service packages. This study had formulated and developed the key instruments and techniques involved in purchasing and providing rural public health service packages by government, such as the cost estimation method of service package items, the development of contract management text, research on service procedures and specifications and supervision, performance standards and evaluation methods.5. Combination of the theories of provide of the rural public health services packages and empirical analyses, on the basis of the conditions of implementation of provided models for government purchasing and systematic analysis of critical link, propose the measures and proposals to promote and improve the implementation of the mode, including that specific the funding responsibility of government, improve the financing structure of government; making planning for services provided and development, define the scope and content of services purchasing; strengthen the construction of primary service institution and developing plural subject to produce services; strengthen the government's capacity building and improving the management level in service purchasing and providing.Innovations1. Systematic theoretical analysis and study on the provision model of rural public health service packages had conducted, the establishment of conceptual and theoretical framework of service providing had filled the theoretical space in this field.2. Rely on the practical support of health XI project, the theoretical research achievement had applied to the practice and continued to improved and perfected in practice, the theoretical research thereby of more practical significance in guiding practical work.DeficienciesConfined by research period, information collection and other factors, this study was lack of practical applications to verify actual effect of theoretical research achievement on the provision model of rural public health care packages. The practical verify of this study mainly rely on the implementation of health XI project. Owing to the implementation of project implementation period was relatively short and the effects of public health services was hysteretic, the verifying and assessing of practical effects was not feasible. Therefore, this study was only available in brief description and analysis of the actual operating conditions. The practical effect of the government purchasing model was subject to evaluate systematically in the subsequent studies.