A Research On Community Health Services Demand And Its Influencing Factors In Four Suburbs Of ShenYang

We can provide a strong objective basis for macroeconomic management and scientific decision-making of community health service by understanding the residents' needs, demand and utilization of community health service. The paper, by collecting the data in four Suburbs of shenyang and using some statistical methods, aims to investigate people's demand and utilization of community health service, analyze the effective factors and evaluate patients' satisfaction to the community health service. It is also espected that the thesis can supply a scientific evidence for manager to formular policy, allocate resource reasonably, make the community health service better than before, meet the health service need of residents, make community health service become one of the most important methods to resolve the health problem.MethodsThe paper makes use of questionnaire survey to investigate the residents and patients of community health service centers in four suburbs of shenyang ,and to find out the social demography character, two-week sickness condition and chronic-sickness condition one half year before the investigation,the hospitalization utilization condition one year before the investigation, the intension of hoapital chosen will choose, the awareness to the community health service, residents' needs and utilization to the community health service , the patients' satisfaction degree. The factors were analysed which can affect residents' utilization of community health service and patients' satisfaction degree to community health service on the basis of the study.Document retrieval, field survey and descriptive analysis were employed to investigate and analyze the community health service in four districts of one city in Liaoning province, crosstable Chi-square test, kruskl-wallis H, non-condition logistic regression, optimal-scaling, vague comprehensive estimation were used in the process of document and data analysis.ResultsThe results indicate that: the residents' prevalence of sickness in two week computed by patients is 18. 29% (the male's is 16. 87%; the female's is 19.58%). Their chronic diseases prevalence also computed by patients is 23. 56% (the male's is 24. 41%, the female's is22.41%). The two -week consultation rate is 8.37% (the male's is 8. 78%; the female's is 8. 01%). The ratio of those who should visit a doctor but not is 54.26% and the main reasons are lack of money, the unserious sickness, and self-cure. The hospitalization rate is 8. 57%, the rate of those should be hospitalized but fail to do so is 45%, and the main reason is lack of money. As for the choice of health organization to visit, if one is suffering from a minor disease, he will go to the drug store and buy some drugs, or to community health service, or to the district hospital, but if suffering from serious disease, he will go to the secondary or tertiary hospitals for treatment. The main reasons for choosing community health service are convenient, better attitude, and rational price. The main reasons for not choosing are as follows: residents do not believe the technical competence, and not understand the community health service, and not satisfy with the installations. In the last year, 499 residents went to community health service in this study, and the rate is 32. 38%.The factors of effecting the utilization of community health service were analyzed with the methods of non-condition logistic regression and optimal-scaling. The result of non-condition logistic regression includes that: the residents who have been retied or laid off, and whose income pre-year is between 2000 and 8000 RMB, and who have chronic disease, and who know there is community health service near home and know the service time, and who choose community health service when they are uncomfortable, and who have listened the lectures hosted by community health service tend to choose community health service. The community health service that is collective ownership, and held by better hospital, and higher rate of general medicine training, and higher rate of supplying services, and lower-cost of average prescription can attract more patients. The final factors of optimal scaling includes that: the residents' age, culture level, job, income per-year, suffering from chronic disease, knowing the community health service nearby, patients' choose of hospital, residents' intension of choosing community health services having listened the lectures hosted by community health service, CHS' system ownership, principal part of conduct, construction area, the rate of senior title, the rate of general medicine training, the rate of supplying services, the price of average clinic prescription, the average expense of clinic and emergency.The paper analyzes the satisfaction degree with the community health service in the method of vague comprehensive estimation. When the weights are equal, the unsatisfaction degrees sorting from big to small are staffs' attitudes, the convience community helth services, waiting time for seeing a doctor, technical competence.Conclusions1. The groups whichmost need community health service in four Suburbs of ShenYang are older residents,less educated residents,poor residents and redidents suffering from chronical illness.2. The demand for health care should converse to the need gradually.3. The utility of community health service is not very welldue to the less understanding of community health service, and there is a unlikeness between needs and actual utility.4. The patients' satisfaction to the community health service varried from very dissatisfied degree to generally satisfy degree, the most unsatisfaction are the equipment and the price.5 . Through analyzing the demanding and supplying factor of impacting community health service, it is conclude that: we should develop the community diagnosis, and determine the key residents' group of service, and intensify the training ratio of general practitioners, and strenghten the technicallevel. At the same time, the government should also strengthen policy guidances' input funds to the community health service, and control the service price withen reasonable bounds.