Study On Ensuring Mechanism For Basic Health Services In Rural Areas After Township Health Center Privatization Reform: A Case Study In Nantong

Objective: The analysis gives full understanding about the status of township medical institution and rural prevention and health care system of Nantong and the provision of health services and the effect of the New Rural Cooperative Medical System (NCMS) on the village residents'basic medical and health services, so as to exploring appropriate protection mechanism of basic medical and health services in rural areas and put forward some experience on it for similar regions.Methods: Grassroots health facilities including township health centers(THC), township public health centers(TPHC) and community health service stations(CHST), health administrators and managers of health facilities, chosen from Rugao, Tongzhou, Rudong in Nantong, were studied through the method of literature research and a combination of quantitative and qualitative survey.Results: Rural system of disease prevention and health care was improved after THC privatization, though problems still existed. The quantity of rural health personnel decreases while the quality remained at low level; medical expenditures in township medical institutions increased rapidly; despite the good development trend of THC, the management status was deteriorating; rural community health service should be undertaken by the cooperation of institutions, because of difficulty in cooperation in practice and difference in systems and operational objectives among institutions; separation of medical service and disease prevention made the latter lack of clinical support and need to be improved in efficiency and quality; Peasants enjoying new rural cooperative medical system, the flow of whose visiting to hospitals is irrational, have a relatively higher hospitalization expenses in township hospitals .In a word, there were still many problems in rural basic health care security after the reform of township hospitals.Policy recommendations: The government role and function in guaranteeing rural basic health care, which include increasing financial assistance for THC and construction of health personnel, should be specified and strengthened; integrating THC and TPHC to improve the efficiency and quality of public health service; integrating township hospitals to make them join in providing public health service and basic medical service collaboratively; improving the serving ability of private township hospitals; strengthening supervision and cost control in order to elevate the efficiency of NCMS fund.