Study On The Supply Ability Of Mental Health Service In Chongqing Mental Health Institutions

Research objectiveBased on the theory of public goods and external effects,to investigate the status quo of mental health service supply of mental health professional institutions in Chongqing,in order to understand the mental health service capacity of mental health professional institutions in Chongqing,and analyze the existing problems and the possible influencing factors,and on this basis,to explore ways to improve the supply capacity of mental health service.Research method1.Documentation method.The paper mainly uses literature review to collect,classify and summarize the relevant research literature,policy documents and government work reports from the field of mental disease at home and abroad.2.On-site investigation Method.On the basis of literature analysis and research,combined with expert consultation and repeated demonstration to made a questionnaire and interview outline of mental health service supply capacity for mental health professional institutions.Based on the economic development status and location characteristics of Chongqing,the investigation site was randomly selected from the five functional areas of Chongqing to investigate the ability to provide health service of mental health professional institutions.The sample of 5 district(county)respectively,Jiulongpo District,Beibei District,Jiangjin District,Kaizhou District and Youyang county.The questionnaire survey of mental health institutions mainly concern on the status quo of human resources,economic operation,infrastructure configuration and intensive interview health planning committee leadership of the sample district(county)and in charge of leadership of mental health professional organizations and staff.3.Statistical analysis Method.Encoding and data input the questionnaire,using Excel to collect the samples,and analysis the status quo of human resources,economic operation and infrastructure configuration of mental health professional organization on multi-level,multi angle.Research results1.The aspect of human resources for mental health in the mental health professional institution:(1)There are 1.73 psychiatrist and 2.75 psychiatric nurse in one hundred thousand in the five sample counties.(2)The psychiatric professions only include psychiatrists,nurse and medical staff,but the control operators and rehabilitation technicians are lacked.The loss of psychiatric professional person from 2013 to 2015 reached 33,and 29 professional were brought in.(3)Although mainly psychiatrists are undergraduate students,18 psychiatrists own the intermediate-level and junior degree.It's nearly account for 20.69%of the total psychiatrists;Nurses and medical technicians are based on junior college,and each of them account for 55.80% and 46.94% of the total psychiatrists.Mainly of them are with primary title and neither of nurses or medical technicians is with senior title.Besides,some psychiatrists,nurses,and medical technicians are without any title.2.The aspect of economic operation in the mental health institution:(1)The government financial aid in the sample counties is 224.96 million in 2013,264.55 million in 2014 and 312.04 million in 2015.Each of the year account for 21.43%,21.80% and 24.19% of the income of mental health institution.That's not enough to pay the outlay of stuff.It's 227.45 million in 2013,356.97 million in 2014 and 389.90 million in 2015.(2)At present,workers and residents of Chongqing,the cost of hospitalization of mental illness according to different reimbursement standards for different levels of psychiatric hospital implement single disease bed by day settlement,but because the reimbursement standard is too low,affecting the patient's treatment,so arrears are serious.(3)The average debt rate of the mental health center was over 40% and the worst debt rate reached 80.45% in the sample counties from 2013 to 2015.In 2015,three mental health centers' total debts are more than 40 million.3.The aspect of facilities and equipment of the mental health professional institution:(1)The instruments which have been used for more than 15 years are accounted for 2.88% of total equipment.The instruments which are used for 10 to 15 years are accounted for 11.06%.The instruments are used for 5 to 10 years are accounted for 38.46%.Imaging device,EMGSEP and test equipment are obsolete.And CVFT,transcranial magnetic stimulator and etc are in short supply.(2)There are only 570 authorized beds,but the actual opening beds are 1250 in sample counties.The usage rate is more than 100%,and the highest reached 110%.(3)The built area of per bed is at least 11.23 square meter and the largest is 23.33 square meter.The ward is so small that some equipment can not be placed.Research conclusion1.Human resources problems for mental health of mental health professional institutions:(1)lack of authorized for mental health professionals,lack of professional personnel.(2)Structure of mental health professional is irrational,brain drain problem is serious and talent introduction is difficult.(3)Professional quality as a whole is not high.2.Problem in the economic operation of mental health institutions:(1)The government has a low recurrent expenditure financial aid for the mental health centers in the various districts(counties),and the mental health institutions run weakly.(2)Health insurance payment methods does not meet the business characteristics of mental health institutions,resulting in a large clearing balance.(3)Some mental health institutions,the scale of debt is too high,and the financial risk is great.3.Professional facilities and equipment problems of mental health institutions:(1)Infrastructure is old,and the necessary professional equipment is short.(2)Lack of beds in psychiatry,and bed usage rate is too high.(3)A serious shortage of business space.Policy suggestion1.Improve the mental health service personnel construction,build scientific development planning of mental health manpower,allocate mental health human resources rationally,strengthen mental health personnel training and optimize the mental health talent structure.2.Clear and strengthen the government's responsibility of financial investment,strengthen government financial investment force,improve the level of daily operating expenses,and enhance the mental health services supply capacity of professional institutions.3.Raise the payment standard of medical insurance reasonably,broaden the drug reimbursement scope of medical insurance.4.Allocate mental health hardware facilities scientifically,equip with the necessary equipment.