Empirical Research On The Performance And Influential Factors Of Community Public Service In Underdeveloped Area

Public health is a public utility targeting on pushing forward the development of public health and improving its performance is the embodiment of the implementation of"people-orientated" concept.Community public health service is not only the junction point of equalizing basic public health service and deepening the reform of medical and health care system of China,but also the main content of "everyone enjoying medical and health care"target.Community public health service takes an important mission in respects of the purpose and function of public health as well as the mission of national reform on medical and health care system.Especially in areas with underdevelopment,the performance of local community public health service is closely connected to the implementation of equalizing basic public health service,and has an explicit effect on deepening the reform of medical and health care system of China.Given the situation above,with the focus on underdeveloped areas,targeting on the performance and influential factors of community public health service,by quantitative analysis on the relation between performance and its influential factors,this work reviewed and generalized the key points of the performance issues in underdeveloped area to offer enlightenment to improve the performance management of community public health service in underdeveloped area,also provided empirical test data and practical supports.The main work is as followings:First,with systematic organizing and summarizing previous works,basing on their theories,Structural Equation Modeling(SEM)was used to build the structural concept model for the performance and the relation between performance and its influential factors of the community public health service in underdeveloped area,with which the research hypothesis was proposed.Second,basing on the data from sample areas,with SPSS and AMOS data analyzing,the concept models and hypothesis were testified,and the empirical testing results were analyzed,discussed and explained to offer testified supportive data for further review and enlightenment on performance management.Third,basing on the testified empirical results,the key points of current performance issues of the community public health service in underdeveloped area were reviewed with influential factors to provide practical solutions to performance management.Last,with the support from both empirically testified data and actual evidence,the enlightenment on the performance management of the community public health service in underdeveloped area was concluded.Therefore,this study is given a basic frame of mind to improve the performance of the community public health service in underdeveloped area at the same time,also targeted to promote its influential factors that play a positive and active role have very obvious significance.The three major innovations of this work are:First,the inner relation of the influential factors of performance in the comunity public health service in underdeveloped area are presented in a quantitative way,and each factor's contributions to the performance in the community public health service in underdeveloped area are calculated to provide a reference and an idea for improving the performance of the community public health service in underdeveloped area.Also,this research is a beneficial trial to comprehensively understand the theoretical application of the performance in the community public health service in different underdeveloped areas with different backgrounds.Therefore,this research itself is extensible itself.This work,starting from the perspective of government performance management,putting the theories into public heath service,focusing on underdeveloped area,built a structural model for the performance of the community public health service in underdeveloped area with factors of investment,operation and effect,and calculated each factor's contribution to the performance of the community public health service in underdeveloped area.The result shows that operation makes the greatest contribution to the performance of the community public health service in underdeveloped area,investment the least.Therefore,with the difficulties of insufficient economic development,limited investment and serious public health problems,the factor of operation should be concerned first.Second,with the shifting of its focus from the macro-search of community public health service performance to the more operative micro-level,this work attempted to find out new data and actual evidence which reflect the factor's influence on the performance in a empirical perspective to make sure that the enlightenment of the management on the performance of the community public health service in underdeveloped area would be more scientific and targeted.Thus,this work has enriched and developed the frame of the research on the performance of the community public health service in underdeveloped area.When implementing,this research followed the basis of area performance diagnostic frame of the World Bank and Harvard University,built the relation model for the performance and its influential factors of the community public health service in underdeveloped area,proposed that the performance of the community public health service in underdeveloped area was influenced by five variables:organization management,resources allocation,payment method,supervision and behavior change.In addition,the impacts of each variable on the three performance factors were specifically quantified basing on the data from sampling areas.The result showed that the five influential variables have the strongest total effect on the factor of operation of the community public health service in underdeveloped area,payment method have the strongest effect on investment,and behavior change influences the most on the factor of effect of the community public health service in underdeveloped area.Meanwhile,among the five influential variables,organization management has positive effect on the other four and the most direct effect on payment method.The conclusion of this empirical result provided data evidence for the enlightenment of the performance management of the community public health in underdeveloped area.Around the five influential variables,this research found and concluded the key points of the issue and offered practical evidence for the enlightenment of the performance management of the community public health service in underdeveloped area,which has a significant meaning on helping the underdeveloped areas clearly realize the issue and improving the positive and active of these influential variables in a targeted way.Third,while building and testing the models,with integration regression and path analysis as well as structural equation modeling(SEM)of confirmatory factor analysis as testing tools,this work avoided the usual restriction that regression model can only explain the relation between one dependent variable and one or several arguments,and revealed the relations between structural factors and between performance and influential variables.Therefore,this research has more scientific,reasonable and systematic analyzing results,and is an innovative application of new tools into new problems.