Study On Factors Affecting Performance About Township Health Center Of Sichuan Province

Objective: To establish a township health center key performance evaluation system. And then to analyze the construction present situation and the performance present situation about township health centers of Sichuan Province, revolving the evaluation system. Finally, research the factors affecting performance about township health center, and propose how to improve the township health center performance.Methods: The first step, research the way to establish a performance evaluation system by literature research, and then establish a performance evaluation system about township health center by Delphi method, unifying the function of township health centers. The second step, take the Qinba project as the backing, investigating 36 township health centers, which are chosen from Tongjiang County, Cangxi County, Yilong County, Langzhong County, Sichuan Province. Those health centers including 27 township health centers and 9 town health centers, with 9 township health centers involved per county. The investigation has used questionnaires to survey 36 township health centers, 33 chief presidents and 15 vice-presidents, 223 staffs, and 172 patients. On another way, the investigation has interviewed 36 presidents and 36 staff groups. The contents mainly include the construction present situation and the performance present situation about township health centers. The third step, analyze factors affecting performance about these health centers by multiple linear regressions, basing on the former two steps, as well as importance of these factors. The fourth step, proposed the suggestions to improve performance about township health center. Results: The findings contain four parts,1. The performance evaluation system basing on the Balanced Score Card contains four key indexes, which are health personnel person yearly average service income, health professional person yearly average outpatient, staff degree of satisfaction, patient degree of satisfaction. And their weight coefficients are 0.266,0.195,0.204,0.335.2. The president qualities, human resources quality, main equipment disposition level and management ability of these investigated township health Genters are lower than those of all the national township health centers or do not meet related requires.3. The health personnel person yearly average service income of investigated township health centers in year 2005 was 28100 Yuan, lower than that of the nation average level in year 2002. The health professional person yearly average outpatient of investigated township health centers in year 2005 was 1143.8, much higher than the nation average level in year 2002. The staff overall degree of satisfaction investigated township health centers is high, but are not satisfied. The patient overall degree of satisfaction of investigated township health centers is high, but is not high in the economy efficient aspect appraisal.4. The factors influencing the health personnel person yearly average service income may be concluded as equipment, management, and national policy. The factors influencing the health professional person yearly average outpatient may be concluded as demography characteristic and human resource quality. The staff degree of satisfaction could be influenced by staff individual characteristic; the 10 dimensions constitutes the staff degree of satisfaction are not equally important to the staff degree of satisfaction. The township health center type and the patient type can affect the patient degree of satisfaction; the 4 dimensions constitutes the patient degree of satisfaction are not equally important to the patient degree of satisfaction. The factors influencing the total performance may be concluded as management and service. Conclusions: Overall, performance about township health centers could be influenced by interior and exterior various factors. These factors have included: main equipment disposition, human resources quality, service, management, national policy, and local social demography characteristic. But, these factors all have problems in the varying degree, which can have the adverse effect to the performance. The government and the township health center own should improve the performance through the corresponding measures.Suggestions: Firstly, the social efficiency first principle should be persisted, and the opportunity of the new rural cooperatives medical service implementation can be used. Secondly, government should strengthen its responsibility: speeding up the township health center standardization construction, strengthening s the township health centers staffs to safeguard, implementing administration side performance evaluation. Thirdly, the township health centers should strengthen their interior construction: implementing standardization management, carrying out the human affairs system reform, strengthening the human resources construction, improving the grade of health service, constructing township health center culture.