| Objective:According to the national deployment requirements since 2000, institutional mechanisms at all levels of the National Health Authority kicked off the reform.’Via more than ten years remarkable and effective work, new health supervision system has been basically formed. But there are still some problems in the reform; including the allocation of resources has become fundamental issues that seriously affect the development of health supervision. This study was designed to evaluate the fairness in the set up of organizations and resources of health supervision and their distributions of 14 cities in Gansu Province; and to fully, accurately grasp the actual construction of the effectiveness of the system and the problems facing the 14 health supervision systems, providing the necessary basis for further promoting evidence-based cities and states of health supervision systems’construction and reform.Methods:In this paper, softwares such as WPS2007 and SPSS 18.0 are applied for data collection and analysis. The norm methods are used for data analysis component ratio, growth rate analysis, different years’comparative analysis, and comparative analysis between different regions and with national construction standards or requirements were analyzed. And investigate by health supervision personnel interviews and questionnaires via health authorities and health oversight agencies. Combining the Lorenz curve (Lorenz curve) and Gini coefficient (Gini coefficient) methods, the status of 14 prefectures Health Authority in Gansu Province since 2009-2013 (On-the-job personnel, health inspectors, checkout equipments of more one thousand "Vuan and all equipments more than ten thousand "Viian) and configuration of the geographical distribution of the population are analyzed.Results:1. An overviewBy the end of 2013, Gansu Province has established a provincial, city and county (district) levels altogether 92 health oversight agencies, established the basic sound level health supervision system. According to statistics, the province’s 92 health oversight agencies at all levels, lack work positions, manpower, as well as the administrative levels, the nature of non-uniform personnel issues; and the uneven distribution of personnel, the number did not meet minimum staffing requirements of national standards.80 of the agencies,80.87%, have applied the civil service management, and 12 of them have applied the management from public institutions.15.2%of the agencies (14) are of deputy director level and 84.8% of them are of Keji level.2. Resource configuration(1) Human ResourcesBy the end of 2013,14 cities and prefectures in Gansu Province health oversight agencies in the total number of personnel for the post 535,34.28% decrease compared with 2009,5-year average annual growth rate of-9.96%, total staffing of 561 people,31.50% decrease compared with 2009 5-year average annual growth rate of-9.03%, the average health oversight agencies owned supervision and law enforcement officers who have 38.21. In every million people in the configuration, Jiayuguan City Health Authority staff the highest density of 0.72 people per million people, Silver City, the lowest was 0.08 persons per million people, a difference of 9 times. Geographical distribution, Jiayuguan City Health Authority staff the highest density of 85 persons per ten thousand km2, the lowest was 0.78 persons per ten thousand km2, a difference of up to 109.0 times.(2) Material resourcesBy the end of 2013, the average city state oversight agency work space area of 2028.75 square meters, five-year average annual growth rate of 1.85 percent Housing construction area using only Lanzhou, Tianshui City, Pingliang and Qingyang four oversight bodies to reach the national standard of not less than 2400m2; the Jinchang City, Jiuquan City, Gannan three institutions has not owned housing property; capita housing construction area and onry 5 cities, Baiyin, Pingliang, Jiuquan, Qingyang City, reached the national supervisory authority of less than 40m2 construction standards. 35.71% city states reach more than 60% in the rapid detection device configuration configured rate. 42.86 percent city states reach more than 60% in the allocation of law enforcement forensics tools, and 78.57% reach more than 60% in office equipment configurations.. The province’s cities and states health oversight agencies now have73 law enforcement vehicles in total, an average of 5.67 per supervision and law enforcement personnel with a law enforcement vehicle,21.51% lower compared to 2009, with an annual decreasing of-5.87%. The number of equipments of more than a thousand Yuan decreases from 402 in 2009 to 340 in 2013,15.42% lower compared to 2009, with an annual decreasing of-4.1%. The number of equipments of more than ten thousand Yuan decreases from 178 in 2009 to 171 in 2013,3.92% lower compared to 2009, with an annual decreasing of-1.0%.(3) Economic OperationBy the end of 2013, the total funding of the province’s cities and state health oversight agency for 54,670 Yuan, five-year average annual growth rate was -1.16%, of which 486.51 million "Yuan government investment funds,89% of the total funding, compared to 2009 fell 2.65 percent, five-year average annual growth rate of -0.67% in the five years since the reform and development of the construction system is basically not much change, but there has been a downward trend. In terms of expenditures, expenditures in 2013 amounted to 51,607 thousand, five-year average annual growth rate of -2.46%, from a structural point of view expenditures, personnel costs and utilities expenses also increased and then decreased after the first presentation of the situation in mid-5 average growth rate was -4.09% and -5.88%.(4) Asset allocationBy the end of 2013, total assets and fixed assets of the province’s health supervision system were 79507 and 57774 thousand Yuan. Five-year average annual growth rates of 9.18% and 5.7%. Each institution’s total assets and fixed assets 5679.07 and 4126.71 thousand Yuan, five-year average annual growth rate of 9.18%,5.7%. Among them, Lanzhou City has the highest total assets, reaching 17083 thousand Yuan; Wuwei City has the lowest, only 1042 thousand Yuan. Fixed assets are highest in Qingyang City, for 16134 thousand Yuan; the lowest in Wuwei City, only 40 thousand Yuan.3. TrainingAt the end of 2013, the province’s municipal health oversight agencies statewide have trained 673 people in total, with an average of 45.5 people per city. Total number of the trained people in Gansu Province and the city level health supervision systems decreased -6.93% and -6.93%, separately.4. reasonable in terms of the allocation of resourcesFrom 2009 to 2013, Gansu provinces state-level health supervision resources (the total number of staff in post supervision, health supervisors, a few million more equipment, more than a thousand dollars to detect the number of devices) by the average Gini coefficient were 0.1506,0.1716,0.3816 and 0.3908, the geographical distribution of the Gini coefficient greater than 0.48. Gansu provinces and the state health supervision rational distribution of resources are relatively poor, which is superior to the geographical distribution of the population distribution. On-the-job personnel, health inspectors have better fairness than the checkout equipments of more one thousand Yuan and all equipments more than ten thousand Yuan have the worst fairness.Conclusions:1. Health supervision systems have been basically established in Gansu at the level of province, city and county (district). But health oversight agencies as the nature of the administrative law enforcement agencies are not yet clear and the levels don’t match, which hinder the development of health supervision.2. Provinces-and state-level reform health surveillance systems and mechanisms are progressing smoothly in Gansu and the team takes shape. But the actual number of staffing and tasks still cannot meet the need of the province’s health supervision. Staffing was low as compared with the total population, so it failed to comply with the relevant national standards. And supervisory staffs are unevenly distributed among regions.3. Reform health oversight agencies show imbalance in Gansu. Regions such as Lanzhou and Tianshui are superior to underdeveloped regions in the personnel structure, investment funds, and office equipment.4. Health Authority has increased funding during the past five years, but still cannot meet the normal operation and development agencies. And the inter-regional distribution of funds is not balanced.5. Infrastructure has been improved, but the work space and the basic law enforcement equipment configuration still did not meet the national minimum standards, and varied significantly among different regions.6. Fairness of the province’s population cities statewide health resource allocation is superior to geographical fairness. A major health oversight resource at this stage is the allocation of resources according to population. Regional allocation of geography Health Authority resources should be further strengthened. |
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