Research On Geographic Information Of The Community Health Service In Chongqing City

Objective: (1) Through the study on the design and foundation of the information management system of Chongqing community health service (CHS) institution based on GIS, the objective is for the health administration department to be frankly straight know the status of the geography distribution of the CHS institutions, and provide a new idea and method to raise the quality and efficiency of information management.(2)To Evaluate the distribution equity of geography area and population of health resources of the CHS centers in main districts of Chongqing, find the problems of the allocation of the community health resources on geography area and population distribution, and provide the scientific basis for government optimizing allocation of health resources in Chongqing City. ( 3 )Investigating the geography status of the CHS institutions and analyzing the influence of geography to the CHS, to find out the effect factors of the geography hindering the development of the CHS, and based the results, we can provide the principles and suggestions of the CHS institutions planning in reason.(4)Investigating and analyzing the willingness of selecting CHS institutions in first diagnosis of the community residents, to find out the influencing factors, including the accessibility of the CHS on geography and timeliness, and some measures should be taken to improve the utilization of CHS among the community residents.Methods: (1) The information management system of Chongqing community health service institution based on GIS is established relying on the support of Mapinfo 7.0 and MapX 5.0, and use Visual Basic 6.0 as the base and Access 2003 as database. (2)The distribution equity of geography area and population of health resources of the CHS centers was analyzed by Gini coefficient and Lorenz curve. (3) 46 community health service centers were extracted by random sampling method, using questionnaire survey, adopt statistical analysis method to deal with the data, including RSR synthetic evaluation, rank sum test and multiple linear regression. (4)We use the questionnaire to investigate 186 community residents, and have Logistic regression and Back Propagation Neural Networks (BPNN) analysis to evaluate the main factors affecting whether the residents chose CHS institutions in their first diagnosis.Results: (1) We establish the information management system of Chongqing CHS institution based on GIS, the function of the database management, the general query, the SQL query, information viewable on the figure and the data analysis is realized by programming. (2)The distribution equity of geography area and population of the health resources of the CHS centers is not reasonable, according to the population, the equity of the institutions and health manpower of CHS centers is better, and their Gini coefficients are smaller than 0.3, but according to the geography, the equity of them is lower, their Gini coefficients are larger than 0.6, the allocation of hospital bed and equipment is inequity on geography area and population, their Gini coefficients are larger than 0.4. (3)The CHS institutions provide less amount of the health service if the district is far away from the institution, the factors of the long distance and inconvenient traffic between the CHS center and public hospital hinder the two-way referral; Many geography factors affect the development of the health service and the amount of the outpatient service, such as the condition of the institution'location, status of traffic, distance between the institution and the center of the community and competition around; through the investigation, we find that the CHS centers are lack of information construction and utilization. (4) 41.40% of the community residents investigated consider to chose the CHS institutions for their first diagnosis. Through Logistic regression and BPNN analysis, factors such as age, education, distance from home, degree of satisfaction to the geography location of the institution, convenience to wait to see the doctor and degree of knowing CHS institution affect the choice and utilization of CHS among the community residents.Conclusions: (1) The information management system has many merits such as convenience and practicality, and we can have a good comprehensive analysis on spatial and characteristic data, offering the scientific basis to health decision-making officers. (2) The equity of resource allocation of CHS centers in Chongqing is not reasonable as a whole, and the health administration department should pay more attention on the geographical equity of health resource allocation. (3) The geography planning of the CHS institution should follow the principle of adaptability, demand, Convenience and strategic decision, avoiding the health service overlapping; and it is necessary to enhance the information construction, in order to ensure the amount of information will be exchanged and shared between CHS institutions and their referral hospitals through the third party.(4) We ought to improve the accessibility of the CHS network, stick to scientific plan, bring the advantages of CHS into play and reinforce the propaganda of CHS, in order to promote the utilization of CHS.