The Study Of Community Health Service Organization And Its Management Based On Hub-and-spoke Network

In this paper, community health service organizations were to study. Learned from the advanced experience of community health service at home and abroad, according to the actual situation in China, we summarized two network structures of community health service organizations: three-tier network architecture and four-tier network architecture. Three-tier network architecture was prevalent in the small and medium sized cities. There?re community health service centers in the streets, community health service stations in the neighborhood committees, family physicians with family responsibilities in three-tier network architecture. Four-tier network architecture was suitable for promotion in major cities. It increased community health service guidance centers to the three-tier network architecture, covered the whole region, unified guidance and coordination of community health service network.This paper added hub-and-spoke network research methods to community health service network to expand research, established a hub-and-spoke network model of community health service organizations based on the existing community health service network. By analysising the model, we divided the community health service center into two categories: hub center and non-hub center, created a hub-and-spoke network of community health service centers in the streets. Meanwhile, the community health service centers and service stations had formed a hub-and-spoke network structure. The hub-and-spoke network of community health service centers coordinated with this hub-and-spoke network, make it more compact in structure and more convenient for internet services. In general, a five-tier network architecture would be constituted, which contained hub centers and non-hub centers in the streets based on four-tier network architecture.The two categories have different basic conditions and future directions. Hub centers pay more attention to medical services, provide guidance and help to non-hub centers, sharing of advanced equipment; non-hub centers lie in public health services, provide comprehensive rehabilitation and preventive health care services to residents. This paper designed appropriate organizational structures for the two categories based on matrix-type organizational structure.Different management methods required to accompany different organizational forms. Based on the five-tier network architecture of community health service organizations, the corresponding internal and external linkage model was established in this paper. The model provided linkage between non-hub centers and hub centers, between community health service centers and community health service guidance centers, and provided linkage between community health service centers and other large hospitals through the community health service guidance centers. This paper also provided the method to create appropriate performance indicators systems of hub centers based on the matrix-type organizational performance indicators system under the internal and external linkage model.