The Research On The Service Ability Of Township Health Centers In Xinjiang

Objective:To understand the development of the service ability of township hospitals, and by analyzing the factors that constrains the development of public health, basic medicine and health management to find out problems and reasons, which is to provide the evidence for improving the rural areas health service system. Methods: Stratified random sampling was adapted to select 11 counties from 89 counties of south, north and east of Xinjiang, and to collect the quantitative data from randomly selected 3 township hospitals from each county which totally selected 33 township hospitals, as well as did the interview with the Director of Medical Services, Director of Township Hospitals, the chairman of the medical departments and village residents’ feedback on the medical service supplement ability. Results:(1) fundamental facility:the building construction and business areas are ideal, the area of hospitals in different region is uneven, the average area in south is the biggest, and the north is the smallest, the area of the clinical department accounts for 26.32% which is the biggest, and medicine department takes more than others. The number of beds per thousand population in the village is 1.77 in 2013, the average number is higher than the national level; the order of distribution rate of equipment in functional departments from high to low is prevention and health section department (89.5%), normal diagnosis department (62.12%) and emergency department (60.97%). (2) The human resource:the fastest increase rate is technical personnel (2.99%), registered nurse accounts for 10.07% which is higher than the national level; the qualification structure of the health personnel is lower than the national level, the rate of technical secondary school and junior college degree is up to 80.69%, and the rate of undergraduate degree is higher than the national level; for the professional titles, the primary title takes up to 77.60%, the level of high title constitute is higher than the national level, and the rest is lower. (3) The basic health service ability:the quantity of service increased from 2009 to 2013, and the number of emergency visiting and observation room case increased fastest which are 26.20% and 25.22% respectively; the average operation rate of basic medicine service is 71.57%, the basic surgery, check-up, diagnosis and treatment is lower than 52.11%; the service rate of the obstetrics and gynecology operation takes up 24.92% in the surgery service; the basic check-up serviced as 90.91% of all the check-up items, the following is special check-up items with the rate of 68.48%, the average operation rate of emergency is 72.96%; the treatment of respiratory system and infectious disease carried out most in the basic diagnosis and treatment, which is over 60%, and digestive system and circulatory system disease treatment is higher than 50%, all kinds of treatment carried out well with the rate of 40%. (4) All basic public health programs carried out well, the residents health files, physical examination, vaccinate and treatment of public health emergency show 80%, health education, management of chronic disease, management of infectious disease, prevention of infectious disease and key crowd health protection carried out over 70%, the community rehabilitation, birth control, management and control of chronic disease, public health management cooperation work operated ranged from 46.15% to 67.48%. (5) Management of public health served not well, but the total implement rate is 77.89%, some programs which caused administrators felt negative rates up to 55.83%; the average management work focusing rate is 51.49%; the main difficulties during work are the short of public health professional staff, short of medical funds, low level of qualification of medical staff, aging equipment, poor implement of rural area health care policies, simple and crude construction of the hospitals and the low demand of professional training. (6) The residents’ satisfaction:the satisfaction on basic medical service is 61.18%, for the public health service is 50.89%. Conclusions:(1) to improve the utilization and update of the equipment, enlarge the net size of business rooms. (2) To improve the talents mechanism, recruit high-quality and practical talents, as well as to provide more chances of studying and training. (3) To improve the accessibility and fairness of the basic medical service, improve the service ability. (5) To enhance the management training, improve the management efficiency and working environment. (6) To improve the medical service comprehensively, and to meet residents’medical service demand.