| The aging of population is an important mark of social civilization, national industrialization and modernization, and also a manifestation of social progress, and improvement of people's health and living standards. As the universal rule, the demand for medical care service increases with the rise in age and fall in health. To guarantee "a healthy old age", we must make great efforts to deal with the challenging issues such as medical care service, economic support, life care, and spiritual consolation.Objectives:The community health service is the basic link of primary health care for every person which is the significant implementation of the concept of social development in a scientific, humane, righteous, stable and harmonious way. The target of community health service is the aged people, so population aging affects the community health service substantially. As China grows stronger, the community health service system will be accomplished, and government will play a leading role for the establishment of a system with proper rules and mechanism to guarantee an effective, economic, and convenient medical care service for every single aged person in China.This research is aimed to provide ideas to build a blueprint of the community health service for the aged people in Chongqing so as to promote the local economic development for the contribution to a harmonious society. Methods:This research is the core of the soft science project of Chongqing Science and Technology Commission's "A research of the Demand for the Community Health Service System by the Aging of Population in Chongqing" and the core of the project of Chongqing education commission "A Research of the Mechanism in the Synchronized Development of Both Community Construction and Community Health Service System in Chongqing City". It is also one part of the Chongqing Development and Reform Commission's project "A research of the Experimental Reform of public Hospitals in Chongqing City". The research methods mainly include literature review, field investigation, normative analysis and interview.Result:The theoretical part of this research explores from diverse subjects such as management, sociology, demography, and economics. This research is theoretically based on the system and culture, and takes the new public service theory (the government management can get effect only if we stress the people-oriented theory and people's livelihood; the responsibility of government meeting reasonable demand of citizens to the utmost extent; to stress the service awareness of government, to strengthen the service functions of government; to emphasize the power and legality of public administration is derived from public, public satisfaction is the final standard of judgment for public administration), the bottom-line equity theory(the aged people can get the most basic social protection by means of basic living allowance and health insurance which are the responsibilities of government. The bottom-line equity is a response to the principled request of livelihood construction, and ensures that the public get the profit of livelihood construction which is consistent with the development of economic and society. That's the Primary responsibility of government, and the bottom-line of government's responsibilities.), the filial piety of Chinese traditional culture (the caring and concern of aged people is helpful to overcome the challenge of aging population. Advocacy of filial duty and filial piety is one of the best ways to harmonious society. Carrying forward the filial piety of Chinese traditional culture can help us to face the challenge of the aging of population in our country and promote the construction of a harmonious society.), the people's livelihood theory (speeding up socialist construction with the improvement of people's livelihood as its focus is a major strategic task brought forward from the seventeenth national congress of the Communist Party of China. Improvement of people's livelihood and social welfare, and all aged people getting physical care and respect are the important content of a harmonious society in China.) and the community development theory (The construction and development of community is a process of cooperation, negotiation and amalgamation of all social departments. The construction of community is a method of solving social problems, and it is an important element of promoting social development.) as theoretical basis for the research, this paper expatiates the demand for community health service system by the aging of population in Chongqing from the perspective of livelihood.In the empirical research,1102 aged people in Chongqing were sampled. The sex ratio of the sample is 1 male:0.78 female, and the average age is 66.4 years. Most of the aged people have a monthly income of 1000-5000 yuan. The educational level of the aged people was generally low.92.82% of participants had basic medical insurance. The Situation of Suffering from Chronic Diseases:the prevalence rate was 63.4%, and the top five chronics were:hypertension, diabetes, coronary heart disease, arthritis and chronic bronchitis. The logistic regression analysis of risk factors of chronic diseases of aged people showed that the prevalence of chronic diseases was related to age, marital status, educational level, housing status and alcohol. The Selection of Medical Care Service:the most satisfactory health care institution was community health service station.56.77% of patients preferred community health service because the community health service was close to their home, the cost was lower than hospital, and the service is good.82.28% of the aged people avoided seeing a doctor when they were ill. The logistic regression analysis of risk factors of avoiding seeing a doctor showed that they were related to gender, job, income, medical assurance, smoking, social activity and individual health care method. The awareness of community health service:All of the 1102 aged people were aware of the community health service centers near their home. Visiting a patient at home was the most familiar community health service (63.91% of aged people were aware of visiting a patient at home). Chronic disease management was the most unfamiliar community health service (only 8.28% of aged people were aware of chronic disease management).81.07% of aged people in Chongqing were not familiar with the policy of community health services. The utilization of community health services:the number one medical institution used by the aged people last year was the community health service station (46.35).45.05% of aged people had physical examination once a year.29.3% of aged people never had a physical examination. The community preventive health care services received by the aged people were mainly blood pressure tests. The appraisal of community health service:most of the aged people were satisfactory with the community health service institution. The defect of facility and the dirty environment of community health service institution most likely made the aged people unsatisfied. The demand of community health service:Some of the aged people in Chongqing wanted the community health service institution provide aptotic general practitioner, some of them wanted the community health service institution visit a patient at home, some of them wanted the community health service institution to establish family sickbed. Most of the aged people thought that the cost of community services of aged people should be paid by the government. The current situation of community health service for the aged people in Chongqing:Most of the community health service centers (94.24%) provided the services of two-way transfer of patients and treated patients in statutory holidays. But few of the community health service centers provided the services demanded by the aged people such as terminal care (17.99%), home-ward (32.86%) and home rehabilitation care (32.86%). The services provided by community health service centers were similar to those by hospitals.The major obstacles for the aged people to obtain community health service:Aged people are excluded by medical insurance system. the distribution of health resources to aged people is unfair. The demand of community health services for aged people is high, and the utilization is low. Ideas of the framework of community health services for aged people in Chongqing are proposed based on the analysis of the obstacles. The responsibility of government must be clarified (Government should be the leader of community health services. Diverse departments should take part in the community health services system. The investment mechanism should be improved.) The community health service system for aged people in Chongqing should be built. (The service system centered on community for aged people should be built to accelerate the construction of community services for aged people. the network of community health service for aged people should be built and improved. The general medical services for aged people in community health service should be strengthened. The mechanism of cooperation and division of health care between community health service centers and hospitals or disease prevention institutions should be built. The two-way transfer system should be established progressively. Community health service medical workers for aged people should be trained.) This research explored the reform orientation of medical security system for aged people in Chongqing. This research also proposes the policy system to establish and improve community health service for aged people and plans the community health service for aged people to increase investment in construction of community health service for aged people. The propulsion of development of community health service for aged people is innovation of system and mechanism. (Social sectors should be mobilized to take part in community health service. Community should take the lead in implementing reform measures such as essential drugs system. The Public health service package should be introduced. The action of creating wealth in old age should be advocated. The budget of social security expenditure should be increased. The industry for the elderly should be developed vigorously.) The basis of community health service for aged people is the construction of the health service team workers.Conclusion:1. Theoretical researchThe political system and cultural type of every society determine the management system of government and the basic organizational structure of social division of labor which is compatible with the system. And the political system and cultural type of the society shape the mode of thinking and behavior of supervisor and supervisee in the specific management environment.This research introduces a way to survey and build the system of community health service for aged people from the institutional and cultural perspective.2. Empirical Study①The aged people are the focus of community health service in Chongqing.②It is necessary to help the aged people to understand the function of community health service so as to increase the utilization of the facilities.③The health projects in use are quite different from what are demanded by the aged people.④The aged people are comparatively satisfied with the community health service institutions in Chongqing. Dissatisfaction lies mainly in the equipment, environment, and professional skill level.⑤Both sides of supply and demand should deepen the understanding of community health service. Government should reinforce the policy guidance of community health service institutions, and increase the investment, and put the prevention and health care of aged people on the agenda.3. Establishment of community health service system for aged people in ChongqingThis research introduces the way to build the framework of community health service system for aged people in Chongqing through the analysis of the major obstacles of aged people in getting basic health services on the basis of theoretical and empirical study. This research put forward suggestions as follows:The health service for aged people in social security system should be improved. A complete health service system for aged people should be established. The public financial investment in health service system for aged people should be increased. The medical workforce in the community health service system for aged people should be strengthened. The mechanism of synchronized development of community health service system with community construction should be implemented in Chongqing.Innovations in the research1. This research introduces a way to survey and build the system of community health service for aged people from the perspective of political system and historical culture.2. This research advocates the concept of synchronized development of community construction with community health care services.
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