Study Of The Reform Of Delegation Management In Linfen Community Health Service Center

Community health service(CHS) is the best way to provide primary health care for urban people, and it is very effective for improving equity, efficiency and health expenditure control. Reviewing community health service in Britain and other countries, World Health Organization brought forward the developing direction of Community health service. From then on, Community health service developed rapidly in the past thirty years.To adapt the new medical model and provide better health service, central and local governments in China has made a series of policies aiming to improve CHS and looked for better reform model. Delegation management was conducted in Zhabei District, Shanghai. It's meaningful to evaluate the reform and summarize the experience.The study contents came from the project named "Study of the Reform of Delegation Management in Community Health Service Center", which approved by the Science Committee of Zhabei, District.The general aim was to analyze the reform process and its effects, summarize the experiences and explore the feasibility of the delegation management to provide information for the further reform in community health service center by evaluating the reform of delegation management in Linfen Community Health Service Center. The specific aim was to study the effect of delegation reform for the management and the service.This case study was conducted in Linfen community health care center, Zhabei District, Shanghai. On the base of collecting relevant documents review, the qualitative investigation and quantitative investigation were applied to collect data as well as the routine statistics. Medline was applied to collect the relating literature data.The quantitative investigation included service amount, the statt's income and the patients' satisfactory to the community health service institutes.The qualitative investigation included the in-depth interview to the director of the community health service institutes, the focus group discussion to the medical staff and the nomination group discussion to thepersons concerned.Descriptive analysis and qualitative analysis were applied.The result showed that object of the reform was clear and definite in Linfen Community Health Service Center. The center improved its competition by better management and expanding service function. The reform works and the results on the management, staff and their income were clear and agreeable. The reform was fully prepared by both the community health service center and the health bureau of the district. The administrator's quality, the center's efficiency, the suggestions from the experts and the choice of the staff were all considered when the administrator being selected. So the decision was reasonable. The result of the reform was good. After reform the service ability was strengthened, the patients were more satisfied with the service and the medical environment, the staff earned more income and they worked with more enthusiasm and the compensation system met the demand of the health bureau of the district.The study suggested that the independence right to the staff of the community health service center should be granted, and the compensation expenditure on the primary care should be improved by adding the amount, changing the mode, establishing the price system for community health service or widening the expenditure resource.