Financing, Personal Management And Analysis On Health Service Provision Of Township Hospitals In Three Provinces

Objective:Identify the main resource for the survival of township hospitals by learning their health financing, find out how those township hospitals manage their human resources, and induct the provision of public health services and basic medical services. Then analyze the influence of health financing and personnal management on the provision of health services.Methods:1. Literature Review:Relevant literatures were collected and reviewed.2. Policy documents Review:Relevant policy documents of national and three provinces were collected and reviewed.3. Quantitative study:Organization data were collected through the questionnaire and analyzed in Excel.4. Qualitative study:In-depth interviews and focus group discussions were organized with policy makers, presidents and doctors of township hospitals.Key findings:1. The main resources necessary for the survival of township hospitals are different in Ningxia, Shandong and Jiangsu. The main source of income for township hospitals in Ningxia is financial assistance, while in Shandong and Jiangsu the primary source is income from pharmaceuticals. Ningxia and Jiangsu have established special public health funding. However, Shandong has no specific public health funding;2. Ningxia and Jiangsu provinces have developed provincial level rules for public health services assessment and Shandong hasn't. Financial assistance is linked to assessment results of public health and basic medical services in Ningxia. Public health funding is connected with evaluation results in Jiangsu, and bonuses of Deans of township hospitals is linked to assessment of basic medical services and the comprehensive assessment of township hospitals. However, Shandong township hospital assessment results only affect reputation, and basically have nothing to do with funding.3. The overall staffing is limited in township hospitals. Presidents of township hospitals are not appointed the right of personnel. Special policies to attract talent to work in township hospitals are established only in Jiangsu. Training for staff in township hospitals of Ningxia and Shandong rely mainly on projects and training opportunities are limited. Health and pension insurance are getting increasing attention and currently only Jiangsu completely resolved medical and pension insurance. Medical capacity of staff in Jiangsu township hospitals is the highest, Shandong is the following and Ningxia is the last.4. Ningxia and Jiangsu are paying increasing emphasis on public health services, and publich health services there are implemented gradually. However, Shandong pays limited attention to public health services. As to basic medical services, there is a tendency of weakening in Ningxia, and the other two provinces have attached great importance to basic medical services.Suggestions:1 Clarify the position of township hospitals and make a appropriate development plan.2 To further increase the government's emphasis on primary health and increase investment in basic health, particularly investment in public health;.3 Prepare the estimation of zero-profit drug policy compensation and explore the best way of compensation4 Increase investment for township hospital construction particular the training of personnel through projects.5 Explore county-level health resources for the training of township medical staff, and institutionalize training.6 Further explore performance appraisal system...