Evaluation On Performance Of Basic Health Services Based On Ground Theory Analysis On Focus Interview

Objectives:To evaluate the effects of basic public health services and to analyze the existing problems in communities of Tianjin,in order to provide decision support for further optimization of resource allocation,implementation of scientific management and promotion of sustainable project development.Methods:1.Residents,neighborhood staffs,medical staffs and directors of community health service centers and relevant managers of health and family planning commission were selected.The main contents of the interview included the implementation of the project,the outstanding problems,the factors that affect the project and the favorable measures to facilitate the development of the services.The grounded method was used to analysis.2.Satisfaction Survey: 180 residents and 360-oriented clients were investigated the satisfaction and awareness of basic public health services.Results:1.Interview analysis results: Total interview time was 329 min,the transcription was 34,692 words.(1)In the open coding phase,there were 703 entries and forming 53 open coding.(2)The above-mentioned open coding formed 16 axial coding."The elderly" and "maternal and child management" carried out smoothly mainly due to the "supply and demand agreement" and the "piece allocation"."Health records management ","health education","management of patients with severe mental illness","tuberculosis patient health management" carried out difficultly mainly due to "no demand-oriented" and "high quantitative requirements".The satisfaction of the medical staff was mainly affected by the " high quantitative requirements ".(3)The core codes related to the topic were as follows:(1)Project leader: project evaluation mechanism,fund management mode,management consciousness,project planning;(2)Project traction: demand-oriented,service mode of operation,training mode;(3)Implement safeguards: project limitations,staffing,departmental collaboration,information construction,management experience.(4)Project results: problems with the project,medical staff satisfaction,approved projects,resident satisfaction,these three modules interact with each other to affect the implementation of services.Project leader was to determine the prerequisites for the operation of the project.Effective project traction had a significant impact on the attractiveness of the project.Project implementation was the basis for the completion of the project.2.A comparative analysis of the results between satisfaction survey and residents' interview:(1)Elderly health management awareness rate is the highest(91.67%),others were less than 90.00%,23.27% of families with hypertensive patients do not understand the health management services for hypertensive patients,in the interview,2 residents mentioned the relevant policy was less,word frequency 7 times,the interpretation of the policy affects the awareness of project.(2)Health education pathway utilization survey showed health counseling sessions and health education lecture have the lowest utilization rates(57.78%),there was a high demand for health education lecture in the interview,but the institution did not accurately address the needs of the residents which affected the project.(3)All respondents were not satisfied with staff technical level and environment and equipment of the institution,the interview mentioned such situation due to insufficient funding for the subsidy and shortage of project professionals.Conclusions: The results suggest that "project leader","project traction","project implementation guarantee" affecting the implementation effect.It is suggested to improve the distribution system of basic health institutions and the performance evaluation of basic public health,to allocate resources rationally through the reform of the supply side,to cultivate talents for the primary health care institutions,while the primary health care institutions to effectively play a policy-oriented results,accurate positioning of service needs,the idealized policy to improve and implement the "medical and health integration" and "team model" and health insurance policy guidance to improve service attractiveness and projects continuity,in addition,strengthen the hardware construction,and further promote the information construction and collaboration between departments.In this study the core codes theory framework provides the theoretical basis for the construction of the evaluation index system of the basic public health service Practical effect,which is helpful to construct the index system in the further.