Study On The System And Sustainable Development Of The Community Health Service In Jinan

The community health service around the world has developed rapidly in nearly three decades. Both domestic and international related research indicate that the community health services is the best way of reducing the waste of health resources in regions and ensuring the availability of low-cost, effective interventions towards chronic illness as well as the medical and health care. The Jinan Community Health Service launched comprehensively in 2003 and with more than 5 years' development, it has initially formed a system framework. However, it is facing many difficulties and problems in process of the development, which has severely impacted and constrained the further advancement of the urban community health services. In order to make a comprehensive understanding of the present state of Jinan's community health services and seek the strategies to promote the healthy development of community health services, this paper will make a shallow analysis and research of the present state and issues of Jinan's community health services based on the basic theories of the public management science with the first-hand materials obtained through the survey on the baseline.This paper has made a detailed description and analysis of all community health services'operation in Jinan from perception of the community health services' internal operational mechanism and the external support system as well as the community health services' consumers. Then we get a conclusion that there are three issues on Jinan Community Health Service. The first issue is the community residents' scarcity of awareness, understanding and trust of community health services and their less access to the services. Through the interviews of the community health services' consumers ,we found their so-called understanding of the health services is only limited to "convenient medical treatment", " door-to-door service " and promotional materials", which demonstrates that they know little about the community health services' other functions with the ambiguity of cognitive state. The second issue is the Community Health Service itself's lack of vitality. The main problems are lower quality of human resources, irrational structure, poor medical equipment, sluggish fund-raising channels, unreasonable compensation mechanism. Moreover, there is still certain disparity between the "Six in One" system and community health services which still focus on health care. The Community Health Service is in the absence of effective management measures, achievement inspections and reward and punishment systems. The management and use of information system are inadequate and there is blindness in services provision. The third issue is insufficient external support systems, for example, insufficient government support manifested in two aspects, namely, both hardware and software supports. The main problems of hardware support are no start-up funds and inadequate funding of public health and no certain amount of subsidy for the completely free public health service such as heath service and education service and so on. The software aspect's insufficiency is mainly the shortage of policy formulation and implementation, followed by non-relevant documents clearly positioning the community and health services' functions which are difficult to implement as a result of the inter-departmental conflicts for interest, such as family planning services, maternal and child care services and so on.This research in view of the above issues proposes three suggestions. First, improve the promotion of the community health service and enhance residents' awareness of health and self-care. We should make residents realize the advantages and neccssity of developing the community health services and help them set up the awareness of "minor ailments in community, serious illness in hospital", which would make residents actively support and cooperate with the service personnels to do the work. Second, strengthen self-construction of the community health services and improve the capacity of the community health service personnel and gradually make the "Six in One" functions of the community health services perfectly, which would benefit the community residents and promote the healthy development of the community health services. Third, intensify the responsibilities of the Government to create a relaxed social environment for the development of community health services. Governments at all levels should earnestly reinforce the leadership of community health services, actively put the promotion of the community health services in the list of the government objectives, conduct systematic assessment, inspection and investigation in order to create a good policy environment for sustainable development of the community health services.