Current Status Of Community Health Services In Beijing

ObjectiveThrough investigating the current status of community health services system inBeijing and evaluating the impact of relevant major policies, the existing problems of thecurrent system were exposed, which will be served as the basis of building a robustoperation and management system for community health service (CHS). It aims to promotethe sustainable development of community health services in Beijing.MethodsThis study investigated the information of all the CHS institutions for its quantity,health funds, staff and equipment, health service and related policy implications. Thesample survey on CHS utilization and satisfaction summarized the information of1,600respondents from64the CHS institutions (including32centers and32stations) by aquestionnaire.ResultsIn2010,2,298CHS institutions had been built in Beijing (including325health centersand1,973health stations). The budget of health service fee was around1,593,500millionRMB with an annual annulus growth rate of138.3%; CHS special fund was196,383million RMB with the annulus growth decreased by13.8%. The total number of staff in theCHS institution was29,738(including21,096in the centers and8,642the station). Amongthem, the number of registered general practitioners, nurses and Traditional ChineseMedicine (TCM) doctors were1,041,1,851and7,257respectively. There was a short ofthese three kinds of health technology personnel.In the CHS centers, the average number of clinic and emergency patients was65,047.5(2,072.75per doctor) and the number of patients of TCM clinic was10,236.7(3,064.9perdoctor); the average number of clinic and emergency patients was9,875.9(4,468.7perdoctor), in the CHS stations, the number of patients of TCM clinic was1,314.7(2,683.0perdoctor). The health records coverage of the CHS centers and stations were39.38%and53.53%respectively.Beijing had launched the development the community essential drug list,implementation of pharmaceutical unified procurement and centralized distribution,implementation of zero-profit drug policy, development of all the nine items of nationalpublic health services, implementation of CHS institution performance appraisal program,revenue and expenditure management and two-way referral system. The first-treatment inCHS institutions had been launched in seven districts. Beijing had launched theimplementation of general clinic insurance, serious illness and chronic disease clinicinsurance. The deductible and individual payment proportion of the basic medical insurance of employees was1,800RMB and10%respectively, while the basic medicalinsurance of residents650RMB and40%.The average age of patients was51.83years old and the retired people occupied themost of the patient.47.50%of patients used the basic medical insurance of employees topay for their health care fees compared with31.88%of patients used the new ruralcooperative medical insurance. In a variety of CHS,57.63%of the patient went the CHScenter for the medical service and16.81%patients for purchasing medicines. The majordiseases treated in the health care center were upper respiratory tract infection31.78%andhypertensive15.18%. The patients of CHS institutions were highly satisfied.Conclusion and suggestionCurrently the Beijing`s CHS institutions is lack of financial assistance and itsfirst-treatment is underdeveloped as well. Lacking of essential medicines reserves, short ofhealth personals and the slow development of the electronic health record system are thegeneral problems of CHS institutions in Beijing. Consequently, through this research, thegovernment is suggested to increase the financial investment and improve the basic drugsystem. Furthermore, on the term of health care workers, the government shouldstandardize the general practitioners training and expand the number of community TCMdoctors as well.