Study On The Status Of Enterprise On-site Clinic Development In Shanghai

Background:On-site clinic is one way to provide enterprise community health services, which is the supplement and extension to the community health service. The enterprise on-site clinic is a component of the community health service system. Enterprise on-site health services are the health services provided in the workplace for employees, including preventive health care, prevention of occupational diseases, first aid, chronic disease management, health education and promotion, food safety monitoring, reproductive health, prevention and treatment of common diseases.However, the development and management of enterprise on-site clinic is the weak section of community health services, research related to the enterprise on-site health services lacks, the policy guidance from government to the healthy and orderly development of enterprise on-site clinic is very limited. Therefore, it is necessary to study on the status of enterprise on-site clinic development in Shanghai to provide information support to formulate relevant policies.Aim:The present study was to investigate the current situation and the existing problems of enterprose on-site clinics in Shanghai., in order to provide scientific evidence for policy development related to the enterprise on-site clinic in Shanghai, as well as to provide recommendations to promote the healthy development of the enterprise on-site clinic.Research content:1. Understanding the current situation of the enterprise on-site clinic resources available in Shanghai.2. Investigating and analysing the current function of the enterprise on-site clinic in Shanghai.3. Evaluation the current situation of the internal and external support environment of the enterprise on-site clinic in Shanghai.4. Understanding the current demand for the enterprise on-site health services in Shanghai.Methodology:Field survey by questionnaire, individual in-depth interviews and case studies were employed to get original information about the enterprise on-site clinic in Shanghai to analyst the general situation, enterprise on-site health service contents, internal and external support environment and present major problems.Results: 1. The role of the enterprise on-site clinic still was irreplaceable in the field of enterprise on-site health service at present.The present research showed that there was great demand for the health services diversification in the enterprises. In the field of providing the special medical and health services to the employees, the role of enterprise on-site clinic was irreplaceable by the community health service center, especially in the injury first aid, occupational population health promotion, respondedness to public health emergencies, health services of floating population and so on. On the other hand, the diversity of enterprises determined the diversity of enterprise health service needs. At present, the community health service center in Shanghai still did not have the capability to provide the on-site health services to the employees according to the characteristics of enterprise community health service.2. Policy rules and regulations lag was not conducive to the healthy development of the enterprise on-site clinic and effective regulation.The research found that, according to the Shanghai auditing standards, the enterprise on-site clinics agencies in the most of the basic conditions, such as the department setup, staffing, facilities, equipments and so on, were generally not high compliance rate, especially the out-patient clinic was very low. The reasons was that the departments, staffing, facilities and equipments of the enterprise on-site clinics were decided by the features of enterprise health service requirements, and was different from the social'medical institutions which were large and full. At present, the essential auditing standards of the enterprise on-site clinics in Shanghai was still based on the document "on the issue notification." issued on May 4,1998. Health administrative department shall timely make adjustments to relevant policy system, which would be helpful to the healthy development of the enterprise on-site clinics and the effective supervision.3. Human resources was week and could not meet the promotion of a comprehensive health needs of workers.There were universal problems on the medical human resources of the enterprise on-site clinics. The success rate of the medical staff allocation is low, the success rate of health station was 11%, the out-patient clinics 14%, and the health center 80%. On the other hand, medical staff could not completely meet the needs of enterprises community health services, due to the lack of basic occupational health services training. The health administrative departments should formulate relevant policies and systems to enhance the development of the human resources in the enterprise community health services, to adapt to the needs of the workers'health promotion in the new era. 4. Development of enterprise on-site clinic entirely depended on its own investment company but without external support.Lastly, the research found that the most important problem of the external environment agencies to support the enterprise on-site clinics was the lack of policy support, followed by tax incentives and business support. The key of policy support was to solve the lag development of policy and the lack of funding. On the other hand, the lack of high quality health care products in the marketing led to the low socialization degree of the enterprise health services. It is necessary for the government to play the role of policy guidance and direction of public opinion to establish funding mechanism for the enterprise community health service in order to encourage the marketing to provide health care products, so that the enterprises could realize the socialization of the enterprise community health services, and enhance the competitiveness of enterprises.Conclusions and Recommendations:1) Enterprise demand for health services have their own particularity.2) The enterprise on-site clinic helps to solve the problem of relative shortage in medical resources allocation, but current situation of the enterprise on-site clinic could not meet the need.3) The enterprise on-site clinic functions cannot be replaced, but services delivery can be changed to adapt to different needs.4) Medical Administration regulations and management system should be improved, The effective supervision of the enterprise on-site clinic should be strengthened.5) Government policies should play a leading role to promote the healthy development of the enterprise on-site clinic.