The Study Of Kunshan CityHealth Supervision System Construction——Problems And Suggestions

Purpose and Significance of the studyKunshan, a higly developed econimic city, is the first county-level city with GDP of over200billion in China, and has seized top of the100list of the scientific development of small and medium-sized cities in China for seven consecutive years. It has made great contributions to China’s economic and social development. Kunshan’s social development speed is very fast. By the end of2011, the city reached a total population of723,644under registration, with foreign temporary population of1.28million. In2011, the average income of employees of the city was48,158CNY, and20,212CNY for rural residents. Kunshan is one of the counties with the smallest income gap between urban and rural areas.The socio-economic development of Kunshan is inseparable from the development of the health services, and the health supervision is one of the important parts and important pillars of the health services. The effective implementation of the health supervision safeguards the ultimate realization of the health laws and regulations. The achievement of the economic and social development of Kunshan cannot be separated from the escort of the health supervision.The increasingly rapid social development raises high expectation from the health sector, so enhancing the comprehensive capacity of the health supervision is an inevitable requirement to maintain social harmony and stability. This study evaluates the manpower, funds, equipment and other resources configuration, the working performance on the health supervision, as well as the situation of the implementation of the supervision functions of Kunshan City health supervision system, puts forward the corresponding suggestions for the construction and development of Kunshan City health supervision system.Materials and MethodsThis research employed "Scientific Policy-making Procedures", the principle of "Structure-Procedure-Result" and "criterion gap analysis" as the leading research methods, with the combination of qualitative and quantitative methods, in order to evaluate the administration objects, resources, working performance and the implementation of the functions, analyze the problems and its influencing factors, and to explore the building suggestions.We collected materials by field survey, key insider interview, focus group interview and material update analysis methods. Questionnaire is used as the main research tool to investigate the basic conditions and training of the manpower, funds, facilities and equipment, and the implementation of the supervision functions.This study interviewed experts in the field of health supervision, leaders and law enforcement officers in Kunshan City Health Authority (hereinafter referred to as " City Health Authority"), leaders, the town-level supervisor and assistant supervisor in Kunshan City Health Authority Branch (hereinafter referred to as "Health Authority Branch").Key Findings1. Administration objectsIn2012, Kunshan City Health Authority had a total of12,995administrated institutions, including8820certificated organizations, accounting for67.87%, which were mainly including catering units, public places and medical institutions; the provisional certificated organizations and undocumented institutions accounted for27.82%and4.31%, most of which were catering units and public spaces.The administrated persons amounted7095, including3,590doctors, accounting for49.90%, and3,570nurses of3570, accounting for49.62%, etc.2. Manpower, funds and equipmentThe number of personnel of Kunshan City Health Authority had been increasing during2002-2012, with a total of150in2012, and an average of0.75supervisory staff per million inhabitants. Among them, men accounted for74.83%, and women accounted for25.17%; institutional person accounted for90.21%;92.31%obtained the college education, and15.38%received master degree;77.62%got law enforcement qualifications; comprehensive quality score averages7.76points.City Health Authority income and expenses had increased from12.902million,10.317million in2008to16.599million,16.35million in2011separately. Health Authority Branch income had increased from2.965million,22,041,000in2008to4,562,000,15,546,000in2009separately. Using floor area per capita was36.42square meters in City Health Authority. According to the standard of an using area of150square meters,11Health Authority branches were below the standard; According to the standard of40square meters per capita,9branches did not meet.Kunshan City Health Authority had a total of73kinds of rapid detection equipments. Among the types of equipments regulated by the standard for county level health authority, Kunshan made up74.58%.In City Health Authority, the allocation of digital cameras, camcorders didn’t meet the standards, while the allocation of vehicles, site enforcement packages, voice recorder didn’t meet the standards with the shortage of16and19sets separately. In Health Authority Branch, the allocation of vehicles, digital cameras, camcorders, site enforcement packages, voice recorder didn’t meet the standards.3. Working performance and the implementation of the supervision functions(1) Working performanceHealth administrative licensing was mainly concentrated in the food and beverage units and public places, and new conferment, continuity and change were the main licensing business.75.82%of the8820certificated organizations were supervised and inspected at least once per year. Health administrative penalties were mainly taken place in food catering and medical practices, accounting for51.21%and43.13%separately in2012. In2009-2012, the number of complaint reports Kunshan City Health Authority received showed an overall upward trend, especially in the food catering and medical practices, accounting for59.35%and34.13%respectively in2012. During2010-2012, the efforts put into major events safeguards were8215.16man hours,8112.3man hours, and10282man hours respectively, and the number of handling public health emergencies had decreased with only17cases in2012.(2) Implementation of the supervision functionsThe overall implementation rate of all functions is83.24%,"the investigation of the cases" and "the supervision team training and management" had the highest implementation rate, with100.00%and90.70%respectively; health law publicity and education had the lowest rate,38.10%. Among different professional categories, the implementation rate of the Occupational Health was100.0%; followed by "public places" and "Radiation Hygiene" at90.20%and90.00%respectively; the implementation rate of the "medical practice" and "drinking" were lowat68.75%and54.70%respectively; the implementation rate of "the school Health" was the lowest, with only51.50%.Discussions and SuggestionsAfter10years of construction, Kunshan City health supervision system has made great achievements, but there are two major problems:"oversight coverage is not comprehensive, and the functions are not fully implemented". These problems are mainly caused by "inadequate staffs, weak law enforcement","unsound branch office construction", unsystematically information construction, unsatisfactory data quality", etc. In order to solve the problems, this study proposes the following measures:(1) increasing the number of personnel, strengthening personnel training and the management of the assistant supervisor, in order to ensure supervision and law enforcement forces;(2) establishing personnel evaluation mechanism, inspiring staff enthusiasm for the work, and strengthening the branch supervisors’training, stabilizing the source of the funding of the branches, improving branch financial management system, and developing the input standard of the branches;(3) integrating the information systems, improving the data quality, so the information systems can fully play its role in the health supervision system;(4) making use of the GIS theory, to improve work efficiency.