The Status And Countermeasures Of Community Health Service Of Dongguan City

ObjectivesThe great achievements of health career of China have been made since liberation, especially after reforms and opening to outside and the health service system has played a major role in protecting people's health. But the current health service system have been found more and more aspects that aren't appropriate to the people's health need in the period of economy changing. Firstly, the medical expenditure has increased too rapidly and the economic burden of individuals has become heavier and heavier. Secondly, the distribution of health resources is not reasonable and the differences between city and village are too large. Thirdly, the double disease burden becomes heavier, which means people's health are not only endangered by the new emerging infectious diseases but also by the chronic, non-infectious diseases. Fourthly, population aging process are increasing ,leading to the double burdens of population aging and economy. To solve these problems, community health service consisted of primary health care and comprehensive prevention and treatment have been practised in China. Development of community health service can provide the basic health service ,meet the needs of people which increase day by day and increase the people's health level. It also can deepen the health reform, build the municipal health service system which are appropriate to the market economy of socialist and meet the urgent needs of people's basic medical insurances.To promote the healthy and rapid development of community health service of Dongguan, the study will investigate on the current situation and the existing problems of community health service of Dongguan to pilot the feasibility and need of developing the community health service and to find out a community health service pattern which is appropriate to the economic development and people's needs of Dongguan and provide a pattern which can be used for reference by rich regions of whole China.Materials and MethodsLooking up tatistics materials, investigations by questionnaires and field work are used in the study. Subjects: The community health service institutes of Qishi, Wanjiang and Changping were chosen by typical sampling method. The residents from above three towns were chosen by multiple-phase sampling and investigated by questionnaires. Talking and discussion were used in communication with relative leaders from governments and health departments. ResultsThere are 1083 medical institutes, in which are registered and licensed with the certificate of license of medical institutes. 41 medical institutes are built by governments of all levels, 5 are branch hospitals, 171 are community health service stations or clinics. 16 hospitals and 22 clinics are run by social strength. 170 medical offices are run by factories, enterprises and schools. 27 are private clinics and 631 medical stations are run by villages. All towns have at least one comprehensive hospitals run by local government and every village or residents'committee has at least one medical station. Now, three-level health care network has been formed in which public hospitals run by governments are dominant and municipal comprehensive hospitals, town-level hospitals ,community health service institutes and village-level medical stations are main parts. It will take 30 minutes for residents to walk to the medical institutes nearby to seek for medical help.To meet people's urgent need for medical service and based on the pilot work of community health service of Qishi town, community health service are put forward comprehensively according to the community health service pattern of"government support, run and managed by hospitals themselves, service first and attention on long-term effect". Now, 124 community health service centers or stations have been built and run smoothly. A relatively perfect network of community health service has formed preliminarily and to provide good quality medical service with relative cheap cost has been realized. However, there isn't a complete system of policy and the government input isn't enough, the economic burden of town-level hospitals are too heavy, thus hinder the continuous development of community health service .Furthermore, the insufficient labor resources and poor quality of medical technology also decrease the credibility of dwellers on community health service . Now, the community health service can't meet the needs of people, especially in some remote regions. So, it is necessary to strengthen the construction of community health service sites.The satisfaction rate of people on convenience of community health service was the highest(76.5%) and the satisfaction rate on service attitude ranked the second(66 .7%). And the not-satisfaction rate on cost ranked the first(49%) and on service quality ranked the second (16.9%).These results show that in people who have accepted the community health service the satisfaction rate was higher. The community health service is welcome because of its convenience and good service, but the cost and medical technology are the least satisfied aspects. To some extent, the community health service stations are attractive to patients. If it can supply the good quality service with less cost, most patients are willing to visit the community health service stations. But now it hasn't been the truth. Because it hasn't been long to develop community health service in China, especially in Dongguan, and it is still in its preliminary period. Most people know little about it, so it is necessary to strengthen the propaganda on the objectives and significances of community health service .The investigation showed that insufficient input on community health service of government and poor quality of community health service staff are two problems. The government should increase input on community health service and strengthen the propaganda so that people could understand and make use of the community health service better.