Research On Rural Cooperation Mechanism Of National Basic Public Health Service Projects

[Purpose]Define the connotation of the rural cooperation of national basic public health serviceprojects, comprehend the present situation of the rural cooperation of national basic publichealth service projects, analyze the current problems of the rural cooperation of nationalbasic public health service projects, learn the experience of the sample areas effectivecollaboration, build the rural cooperation mechanism framework of national basic publichealth service projects, and put forward to the strategies to improve the present situation ofthe rural cooperation of national basic public health service projects.[Methods]Through the literature database in China and abroad, consult the relevant literaturesabout national basic public health services, the collaboration between the townshiphospitals and village clinics, and so on, summarize the base of the present research, definethe connotation of the rural cooperation of national basic public health service projects.According to the random sampling combined with typical sampling way, select Wenchuan,Wuzhi, Zhijiang and Songzi as sample areas to investigate. Using the mathematicalstatistics methods, such as t-test, chi-square analysis, single factor variance analysis,analyze the present situation of rural public health service institutions about the ruralcooperation of public health services human resources configuration, division ofresponsibilities, budget allocation, supervision and management, professional training, etc.Using logical analysis, analyze the internal logic of the rural cooperation mechanism of national basic public health service projects, excavate the typical characteristics of theoperation subject, summarize the abstractive essential attributes of rural cooperationmechanism. Using mechanism design theory for reference, considering the principle ofincentive compatibility, namely to consider the collaboratio n mechanism and the interestsof the organization and individual to be consistent as much as possible, build the ruralcooperation mechanism framework of national basic public health service projects, andensure the stability and sustainability of the collaboration mechanism framework.[Results]The human resources structure of rural basic public health services is not reasonable.There are some divergences of subjective understanding between the rural public healthservice institutions to influence the rural cooperation. The item compensation of basicpublic health service is not be ensured earmarking, such as funds misappropriation,merging with the compensation of village doctors and national essential medicine system,and so on. The professional training system of rural public health service institutions is notperfect. In the sample areas, the management subject and relation subject are enlarged andthe cost center is established. The item compensation is allocated directly to the rural publichealth service institutions. The refining of division of responsibility provides guarantee tothe better rural collaboration. The performance evaluation system provides evidence for thepayment of the item compensation of basic public health service.[Conclusions]1. The younger and specialized public health personnel in rural grassroots should betrained as soon as possible, to improve and perfect the public health resources in ruralgrassroots.2. The division of responsibilities of basic public health services between rural publichealth service institutions should be scientific and reasonable.3. The mechanism for ensuring the item compensation of basic public health serviceappropriate to the division of responsibility should be established and perfected as soon as possible.4. Introducing market mechanism, market-oriented reform the provision of publichealth service. Improve the efficiency of public health service by government purchase.5. The information efficiency and incentive compatibility related to mechanism designtheory, can solve the problems such as private information and benefit drive of publichealth service institutions. It is feasible to design the rural cooperation mechanism ofnational basic public health service projects.[Innovations and deficiencies]1. Innovations: The present situation, problems and experiences of rural public healthservice institutions about the rural cooperation of division of responsibilities, budgetallocation are analyzed, to establish the basis for the rural cooperation mechanismframework of national basic public health service projects, to provide the multi-angle trainof thought for researching the evaluation and control of rural public health systemperformance. The rural cooperation mechanism framework is demonstrated with logicalanalysis and mechanism design theory. It has some theoretical significance and practicalvalue and fills the gaps in current domestic research in China.2. Deficiencies: The calculation of the percentage of the division of responsibilitiesbetween rural public health service institutions has some limitations, because of justrelating to the subjective understanding of the leaders of rural public health serviceinstitutions, and lacking the data of the percentage of the division of responsibilities fromreality. The research about the influencing factors of the rural cooperation of national basicpublic health service projects lacks of the empirical data to demonstrate. There are somelimitations and one-sidedness in the conclusions.