The Feasibility Study Of The Private Health Institutions To Participate In The Supply Of Public Health Services In Rural Areas

Objective:The study at the basis of comprehensive understanding of the situation and existingproblems in rural public health service, and through literature analysis to learn thetheoretical and practical experience of private service institutions participating the supply ofpublic health services in home and abroad, analyze the feasibility of private healthinstitutions to participate the supply and propose the research ideas,, to identify the mainfactors and propose the social support system to enhance the feasibility of private healthinstitutions to participate the supply.Methods:1. LiteratureRetrieve the domestic and international data reports and related research about thedevelopment of private health institutions and the situation of private health institutions toparticipate the supply of public health services, on the basis of classification to summarizethe main points.2. Scene typical surveyInvestigated the supply situation of sampled country’s public health service and thesituation of private health institutions participating in the supply, and taken questionnairesand targeted interviews to different participation subject.3. Semi-structured in in-depth interviewTaken in-depth interviews with health administrative departments, public healthsystems staff, and the staff of private health institutions to find the affect factors aboutprivate health institutions participating in the supply4. Statistical Analysis According to the nature of the data, use statistical methods to analyze the situation ofthe public health and the key factors of the supply of private health institutions.5. Expert consultationInvited experts in the field of public health services in rural arrears, to understand theattitude to the private health institutions participation in public health services, and judgethe strengths and weaknesses.Results:1. The distribution of the public health resources in rural areas is uneven, and themode of supply is single.The distribution of the public health resources in rural areas is uneven, the number ofresources in eastern, central and west are gradually decreasing, the economic developmentlevel in regions and the number of public health resources is related; the fiscal burden ofgovernment, per-capital health expenditure, and the gap between urban and rural areas; thelack of public health personnel, the overall quality is not high, especially in rural areas; thesupply subject is single, the government is absolutely the main subject, high pressure andlow efficiency, while population aging and the change of disease spectrum will pose newchallenges.2. The development level of public health in sample countries are not balanced, theparticipation of the private health institutions is less.The development level of economic is proportional to the rural health funding andspecial funds of public health. Tuanfeng country is poverty-stricken countries of ournational economy, its funds on every factors are less. The annual basic public healthservices is15in the sample countries, the government of Qianjiang and Jinxiang haven’tstart the project of government purchase public health services, private health institutionparticipated in public health services only in Tuanfeng contry, but haven’t got governmentcompensation.3. The overall quality of private health institutions need to be further improved, andthey have willingness and practical action to participate in public health services.The average net fixed assets of private health institutions have been investigated is132million yuan, average personnel number is38.25, the average revenue is253million yuan, the scale of private health institutions is smaller and the operational capacity needfurther enhanced, the overall level of personnel is not high and lack highly educated andhigh-grade technical personnel. There are policy restrictions in private health institutions toparticipate in supply, but they all carry out social welfare activities, and willing to carry outservices upon the background of policy allowed.4. The recognition of private health institutions is lowThe preferred rate of private health institutions is7%, the rate of often going toprivate health institutions accounted for9.8%, the selection rate of gynecologicalexaminations, the physical examination of pregnant women and children is low. The mainfactor of not choose private health institutions is not trust them, and the main factor ofchoose them focus on proximity. The treatment causes is cold,fever and other commondiseases.5. Experts and scholars are skeptical of private health institutions involved in publichealth servicesThe nature for profit and the quality of services are the main factors that expertsthink private health institutions doesn’t suit to participate in the supply. They also generallyexpressed under the premise of government-led if government can implement the purchasesystem, make rigorous entry and check system, introduce the competition, private healthinstitutions participate public health services have practical feasibility.6. The influence factors of the feasibility that private health institutions participatein public health services in rural areasPrivate health institutions participating in public health services in rural areas hastheoretical and realistic feasibility: the characteristics of Quasi-public goods, the lowefficiency of the single supply mode, the enabling policy of new medical reform program,the current status of private health institutions: considerable number, economic base,institutional base and personnel infrastructure, they involved in public health services cancompensate for the insufficient supply of rural public health and upgrade the entire systemefficiency by competing.Suggestions:1. Build a new model of public health services in rural areas: government-led allocation of resources to ensure fairness; change the concept of government and encouragemarket forces to enter; formulate relevant laws and regulations and set the national standardof public health services.2. Establish the social support systems to improve the feasibility of private healthinstitutions involved in the supply: allow the private health institutions into the nationalbasic medical service system and give equal treatment; change the mode of governmentmanagement and gradually establish a system of government purchase of public healthservices; establish uniform standards for public health and transfer payments by thestandard of public health expenditure; public-private partnership and build themulti-incentive mechanism with weak to sttong; enhance the rural residents’ concept ofpublic health and establish a smooth feedback mechanism.3. Private health institutions enhance own strength and carry on positivecommitment to undertake the responsibilities: large the investment, ensure the facilities andstaff, improve technical level; large strength and less weakness to win in the same technicallevel by service; promote the construction of hospital culture and establish a good image.Innovations and LimitationsInnovations: This study through typical case investigation and analysis, to identifythe main factors and propose the social support system to enhance the feasibility of privatehealth institutions to participate the supply.Limitations: As time and funding constraints,only four private health institutions inHubei and Shandong province were sampled, and the results may be less representative.Interviews includes interview executives of relevant agencies and lack of agencies outsidethe health system. The elements affect the private health institutions to participate thesupply of public health are too many, there are deficiencies in the choice of surveyindicators.