Study On The Service Quality Evaluation Of Premarital Care And Improvement Strategies In Fujian Province

Objective: This study is based on the policy of free and lawful premarital care,evaluate the premarital care service’s structure quality, process quality and result qualityfrom the angle of the supplier and demanders in Fujian province, explore the problemsexisting in the service and the main influence factors, and then present some suggestionsto promote premarital care quality improvement.Methods: Literature analysis, observation, questionnaire and Semi-structuredinterviews methods were used to collect material.Avedis Donabedian’s three dimensionstheory"structure-process-outcome " were used to to make comprehensive evaluationabout premarital care.Statistical description, statistical inference, fairness analysis methodwere used to analyse influential factors about service quality and some targeted measuresand recommendations were proposed.Results:1.In the structure of quality, the policy of free and lawful premarital carehad better carried out, the services network has basically established, but it also had someshortcomings, such as all levels of financial were from25yuan to160yuan，11institutions had no private health consulting rooms,20institutions had no special healthpromotion classroom,16(2.29%) premarital physicians had unlicensed, bachelor degreeor above only accounted for19.29%, the title of deputy high above only accounted for20.97%.2.In the process of quality, the majority of premarital care institutions carried outthe services in accordance with regulatory requirements, but there were also somedeficiencies, such as the unreasonable service process, unsound referral mechanism, theignored premarital health guidance and health consultation, the " only examination but notreatment" premarital check-up and so on.3.In the outcome of quality, the rate of thepremarital medical examination was97.31%and ranked first in the country, the rate of thedetection disease was13.4%and ranked fith in the country. The average scores of thepremarital physicians’ satisfaction are3.55,the last five items of scores were the salaryallocation mechanism（2.88+1.05）, promotion（3.02+0.98）, job autonomy（3.35+0.92）,the opportunities of doing different things(3.39+0.91), hospital policy(3.43+0.9). Thesatisfaction of the physicians which were under the age of35and low-level titles was lower than the people which were over the age of45and intermediate grade.The averagescores of the objectiongs’ satisfaction are4.51.The last five items of the objectiongs’satisfaction scores were the mechanism convenient transportation (4.21+0.95), waitingtime(4.43+0.81), mission40min(4.49+0.78), timely report(4.47+0.81), satisfaction(4.51+0.79). There was significant difference in different gender, age, place of residencepremarital object satisfaction score.Conclutions: With the implementation of the free and legal premarital care policy, thepremarital care service achieved certain results, such as the premarital rate and the numberof detected disease increased, medical guidance respected for the autonomy of citizens, thepremarital objects had high satisfaction, but at the same time the service quality was still tobe improved. According to the shortcomings of the service, quality improvementrecommendations were proposed, inclucding making the minimum subsidies standards,increasing the premarital health promotion, strengthening the institutional standardizationof construction, optimizing service processes, improving the referral mechanisms, carryingout the personalized guidance and counseling, establishing and improving the incentivemechanism and so on, in order to further improve the quality of premarital care services.