Analysis And Strategy Study Of Construction On Primary Care Health Service System In Gansu Province

Objective: The study mainly through the investigation of construction on primary care health service system in Gansu province, to understand the status of the primary care health service system in Gansu province as the new medical reform is carried out, to identify the main problem in the construction of primary care health institutions and health manpower and operation mechanism. To put forward sustainable development strategies and suggestions of primary care health service in Gansu province. To provide necessary frame of reference to promote the construction on primary care health service system.Methods:Taking random sampling for the investigation unit,15counties were investigated in the counties of first start national essential drug systems. Investigation mainly includes the construction of primary care health institutions, the health manpower, the utility of medical service and expenditure. Collecting and utilizing data from Health Statistics Yearbook of China, Gansu Statistical Yearbook and Statistical Yearbook of Health, using health service management, health policy and social medicine and other disciplines related theoretical knowledge, to analyze the construction and development of primary care health service in Gansu province.Results:1. Primary care health service organization construction: From2008-2010, the rate of standard-obtained in county hospital were81.40%,86.05%,97.67%, respectively; the rate of standard-obtained in township hospitals were61.4%,70.93%,77.46%, respectively; the rate of standard-obtained in community health service center were16.67%,68.75%,92.31%, respectively; the rate of standard-obtained in community health service station were21.6%,24.5%,24.5%, respectively.2. The health manpower of primary care health service:From2008-2010, the proportion of health technical personal of the primary health care institutions were88.16%,88.66%,91.29%, respectively. The urban and rural health manpower has become gradually perfect; general practitioners per1000Persons were0.045,0.056,0.063, respectively, the amount is insufficient. 3. The utility of medical service and expenditure: From2009-2010, outpatient visits in basic medical units increase obviously, the average increase rate is29.11%. The expenditure on medical service for an outpatient was dropped from RMB35.97to RMB33.O, falling by8.26%. The expenditure on medical service for an inpatient in hospital per capita was decreased by RMB69.17, falling by7.36%; primary health care institutions on the overall proportion of fiscal revenue increases year by year, an increase of4.23percentage points in2009than in2008, an increase of5.21percentage points in2010than in2009; from2008to2010, drug-income ratio of primary health care sector were35.30%,32.38%,26.35%, respectively, amplitude reduction was25.34%.Conclusions&suggestions:Primary care health service system is not perfect in Gansu Province, it’s affect the Internal service and external image of basic-level medical organization, to accelerate the development of primary health care institutions and rural health service integration; taking avarious ways to introduce, eneourage and train medical personnel, Improve the treatment of basic level sanitary personnel to attract and retain qualified personnel, and make it sustainable; improving the general practitioner in community health service system, Exerted "Six in One" function for the community health service centers, and training general practitioners in various ways, taking the advantages of Traditional Chinese Medicine in Gansu province, develop the general practitioner of Traditional Chinese medicine. Using multiple resources and increasing investment, to improve the operation mechanism of primary care health service system.