Investigation Of Present Status And Countermeasures Of Developing For The Community Health Service In Chongqing City

Objective: Have quantitative and qualitative analysis to the investigation result of CHS of Chongqing City in 2006, and describe the development status of Chongqing, then find out main factors hindering the development of CHS. Finish the calculation of cost for the community public health service, and offer foundation for policy and plan making of the development of CHS in Chongqing.Methods: Adopt description analysis to every kind of interviewer; Have Chi-Square test and rank sum test to the data of staff, patients and inhabitants; Merge the staff data with patients data and inhabitants data separately per region, and have Logistic regression analysis to evaluate the factors affecting whether the residents chose CHS institutions in their first diagnosis. By looking up literature and web resource, analyze and summarize the change of CHS policy.Results: By May 2006, Chongqing City have established new style medical health service system, but there are still some problems, such as: the investment from goverment is lacking severely; the hardware of CHS institutions is poor in general, especially for CHS Stations; it's widespread that CHS institutions support their medicine sevice with drugs-income and their public heath sevice with medicine-income, and the public health service is inadequate; the community health staff's professional level is low, and General Medicine qualified personnels are inadequate; the competition ability of CHS insitutions is weak, and financial loss is common. The main factors which affecting residents' chosing CHS institutions in their first diagnosis are, for patients, service price, surroundings of seeing doctor, distance from home, age of patients, and for inhabitants are convenience of seeing doctor, whether knowing CHS institution existing around home, service price, and whether community doctors provide health guidance to patients and family members. The result of community public health service cost is that one resident need 73.20$ every year. From the latter half of 2006 to now, the CHS reformation have made great break in following aspects: government have invested more financial support; improved the facility and staff standards; applied specific durg and service price management, made CHS drug list; Brought the CHS institution into medical insurance, and increased the reimburse ratio of CHS medical insurance; reinforced CHS staff training; reinforced support degree from public hospitals and so on.Conclusion: Against current main problems of CHS and refering the main fators affecting residents' using the CHS, we recommend the following steps: according to the geography, health demanding and distribution of health resources, as well as area health plan, government should build more CHS institutions to increase the cover ratio; make further investment to CHS to make up the investment shortage of community public health service; by establishing scientific decision information system of community health geographical position, arrange area responsibility between hospitals and CHS institutions reasonably to solve the Dual Referral problem; control the CHS staff training quality and increase CHS staff's treatment; reinforce the propaganda of CHS idea; know and paricipate worldwide general medicine organization and activities to learn advanced CHS experiences and mode.