Study On Utility Of Rural Health Supervision Models In Hunan Province

1. Research ObjectiveThe purpose of this topic is to provide the scientific evidences for establishment and improvement of the rural health inspection system by ascertaining its current situation and constituting a tentative performance evaluation index system of grass-root health supervision and using it to comprehensively evaluate different kinds of rural health inspection modes in Hunan province.2. Research Contents and Methods(1) Research MethodsBy the way of a structured letter investigation to all county health inspection agencies to know the status of rural health supervision in Hunan Province,their work ways were divided into four different modes according to the source of the rural supervisor and their wages, the form of the management, and the content of the work. The samples were selected by using the cluster random sampling which counties were divided three centers according to the economic levels of highest, higher, and lower and one county was sampled in every center and typical survey methods was used to decide the four typical counties of different modes. And a synthetical evaluation study methods was used to research the work performance of four kinds of modes.(2) Research ContentsThe research contents included the requirement and the supply for persons, properties, things and the performance of the health inspection work, and the degree of knowing and satisfaction of the rural residents to rural health inspection, and constituting a tentative performance evaluation index system of grass-root health supervision, and comparing the performance of four kinds of rural inspection modes.3. Main Research Results(1) The four rural inspection modes were as follow. The County of Nan was as typical of the modeⅠin which the branch of health supervision were established in townships and the health supervisor specialized in health supervision. The County of Taojiang was as typical of the modeⅡwith the establishment of health supervision office in township hospitals, the appointment of assistant health supervisor, responsible for routine health supervision and the summary administrative penalty, and worked with the prevention and care as for the two brands under one roof. The County of Xiangxiang was as typical of the modeⅢwith the appointment of assistant health supervisors in township charging area daily health supervision and inspection. The County of Shaoyang was as typical of the modeⅣwith the direct management of county-level health supervision institutions of rural health supervision .(2) The rural population occupied the percent of 78.3 of the total population and the average numbers of the households and employees inspected were 3141.3 and 5502.8 respectively.(3) The mean scores of the inspector comprehensive quality of the four different modes were 5.20, 5.94, 6.24, and 5.25 in turn. The average proportions of having reached the standard of the basic equipment allocations of computer, camera and vehicle of the four different rural health inspection modes were the percent of 81.4, 67.9, 63.2, and 55.0 separately.(4) The per-financial grant for the sample institutions showed increasing trend form 2006 to 2008, and there had marked difference between in different modes (F=23.74, P=0.000).(5) The average fulfillment ratio on the item of function had significant difference among four kinds of modes (P=0.003). And the ratios of the school hygiene, occupation health, radiation health,and the drinking water monitoing and assessment were all lower.(6)The completion rate on time of the health administrative license was the percent of 100.0, and the health inspection frequencies was 3.0 times for every unit, and the complaints and reports were mainly completed in a day with the percent of 61.2 of modeⅠwhich all were the highest of the four mode.(7) All the evaluations of the rural residents on situations of the food hygiene, the rural medical market, the awareness of health supervision responsibilities, the degree of the benefits, and the satisfaction degree and overall assessment means of the rural health inspection work had significant difference(all P=0.000).(8) The first level indicators of the health inspection performance evaluation index system included the input, utilization, performance. And the second level indicators respectively included the numbers on guard, the mean scores of the inspector comprehensive quality, the level of the equipment allocations, and the amounts of the per-financial grant; the performance ratio of the health inspection function, the completion rate on time of the health administrative license, the health inspection frequencies per- unit, the ratio of cases settled and checked, the numbers of using broadcasting or TV for the health and legal publicity and education, the times of per-inspector cultivated, the ratio of the complaints and reports completed in a day, the numbers of the emergency, and the awareness and satisfaction degree of health supervision of the resident。(9) The work performance scores of the four kinds of modes were respective 4.7827, 3.7020, 3.6793, and 2.7598.4. Conclusions(1) The task of the foundational health inspection in Hunan province was heavy, and the supplies of health inspector, properties, things, and basic equipments would be enhanced and balanced still.(2) The work of the foundational health inspection in our province from 2006 to 2008 had been greatly improved as a whole, and all the function especially of the school hygiene, occupation health, radiation health and the drinking water monitoing and assessment related would to be further improved yet.(3) The health inspection comprehensive performance evaluation index system basic on the health inputs, utilization, and performance established in this study can be effectively evaluated the work performance of different modes.(4) The rural health inspection model which the branch organ of health inspection and supervision were set slice in the rural townships and the inspector specialized in heath inspection was superior to the other three kinds of modes and was a worthy of spreading mode with relative optimum performance.