| ObjectsTo analyze the development problems or obstacles facing by the community health service development in Zhangdian district and then finds out its affecting factors in the process of developing. To Put forward the development planning requirements and blueprint with the instructions of national and provincial governments’requirements in these years. In the end, this study might be used to provide a scientific basis for the promotion of community health service development and the improvement the health of residents.Materials and MethodsIn this study, literature review method was used to understand the government’s planning requirements on community health development and to learn the advanced experience of community health development at home and abroad; the information of residents’satisfaction on community health work in Zhangdian District was collected via the questionnaire we designed. Health Statistics Yearbook of Shandong Province, Zibo statistical Yearbook, Zibo health statistics Yearbook data were also used for descriptive analysis to help us make a deep understand of the status of community health development in Zhangdian; Research and expert panel discussion were used to summarize the obstacles exists in the development process.The main results1. Problems exit in community health service development of Zhangdian district The problems including the irrational distribution of community health services institutions, below-standard institution building, and not enough compensation funds give rise to the institutions operator economic pressure, unreasonable human resources allocation for health, unsmooth medical referral channel, imperfect policy mechanism, and the incapability of basic medical and public health services. First influencing factor is the national policy environment and social development, which include the national health reform policies, socio-economic development, demographic changes in the situation and residents of lifestyle changes. Then the community health development plans and standards may also influence the development of community health service. The third one is the geospatial distribution factors such as urban space resources, population density factors, and medical factors distribution institutions. Then the use styles of medical services among citizens also important factors which affecting the community health service.Countermeasures and SuggestionsThe standard 9 community health service centers and 58 community health service stations will be reserved. Then one of the stations should be upgraded to center. The other change including 1 center reposition,1 center expansion and 2 stations being canceled,6 stations reposition 1 station expansion. For areas lack of community health services, this study plan to build a new center and 7 stations with 6 township hospitals transition into centers at the same time. There will be 19 centers and 70 stations totally. All the agencies should standardize the construction in accordance with national requirements.Social capital organized community health agencies should be encouraged in the next years. The proportion of beds and services funded by the social forces should be no less than 25%. In the long-term plan,30% spaces should be reserved for the social institutions.To improve the quality of community health services which include the basic medical and the public health services. The rate of resident’ satisfaction to community health services should be more than 95% in 2020.Transform the service model in the health service agencies. Try to implement contractual services. General practitioners contracted coverage no less than 30% of all the services in 2017. And then fulfill the whole coverage of general practitioners in 2020.Promote the hierarchical treatment system in Zhangdian district. The grading pilot treatment of diabetes and hypertension should be launched in 2016. To the year of 2017, the basic mode of coordination among different medical institutions would be formed. The proportion of community health services in the whole health services should be raised to 6-7%.Strengthen the work of community health personnel construction. There should be an additional 57 community general practitioners,118 preventive health care staff,40 public health physicians and 13 Traditional Chinese Medicine practitioners. All the added health service staff should be assigned to the new community health service institutions or the community health service centers with inadequate personnel.Make a full use of the Chinese medicine services in the next period. The proportion of Traditional Chinese Medicine services should be no less than 30% in 2017. All the community health service centers should run the department of Guo Yi Tang, and the proportion of its Traditional Chinese Medicine services should be up to 30%.2. Policy support measuresAdhere to the discipline of government-led, and to implement the division of responsibilities were the most important measures in the process of developing community services. And new community health regulatory system should be explored in the next few years. The third measure is to increase the financial investment with a strictly management of the expenditure. High practical health insurance social assistance policy is also important as we mentioned in this study. |
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