| BackgroundThe rural health service system in China is basically a three-level health service system that is based on county-level medical and health institutions,township health centers,and village clinics.Among them,township health centers are the main force for providing basic health services to rural residents and have played a huge role in protecting health.The demand for medical and health services from rural residents shows a trend of diversification and hierarchy,which makes rural health services more difficult.At present,China’s township health centers suffer from inadequate government funding,shortage of basic medical equipment,shortage of health service employee,and low level of basic medical service technology.Under these circumstances,it is necessary to conduct a comprehensive evaluation of its health service capabilities conforms to the level of economic development,whether it can meet the needs of basic medical and health services.ObjectivesOn the basis of reviewing the development of grassroots health policy and township hospital,combining with the actual development of NingXia,we analyze the current situation of resource allocation and medical service of township hospitals.Using index system of grassroots health service ability,we analyze the township health centers service capacity in sample area,which let the rural residents receiving the quality of health services,meanwhile providing reference and policy recommendations for the government to improve grassroots health services.MethodsUsing the literature review method to review the grassroots health policies and the development of township hospitals in different periods in our country;Using descriptive analysis to analyze the human resources,material resources,financial resources and medical services in NingXia;Using expert consultation and analytic hierarchy process to build a comprehensive evaluation index system of service capability and calculating the index weight.The weighted TOPSIS method and the rank sum ratio method are used to evaluate the grassroots health service capability in the sample area.Results1.Status of health resource allocation and medical service.There are 194 township hospitals in Ningxia.The total building area is 374,869.00 square meters.An average floor space of 1,932.31 square meters per organization.There are 2342 beds in total.Over10,000 yuan on the total number of 13,17 units.The highest number of staff in total,the total number of preparation staff and the total number of health technicians are all in Guyuan City.The average total asset per organization is 6.13 million yuan,and the average agency debt is 872,200 yuan.The total number of patients was 5944715,and the annual outpatient number was 5688144.2.Build a comprehensive evaluation index system consisting of three first-level indicators and 22 second-level indicators,using AHP to calculate the weights of the three first indicators : resource allocation,medical services and health-related services are respectively 0.5400,0.1630 and 0.2970.3.Resource allocation ability is in upper high level.MHV is in "poor" range accounted for 12.50%,the HV is relatively poor in resource allocation capabilities in backward and outlying areas,UFEQ in the "good" range accounted for 16.67%,two of them are in better developing cities,in the “middle” range,17 households accounted for 70.83%,coming from five cities.4.Medical service ability is in upper high level.HNGC accounted for 16.67% in the "good" range,HGC are in better developing cities,XRB is in "poor" range accounted for 12.50%,XR comes from the surrounding cities,in the “middle” range,17 households accounted for 70.83%.5.Health-related services capability is in upper high level.XGB in the "poor" range accounted for 12.50%,2 from remote areas,KMQH accounted for 16.67% in the "good" range,in the “middle” range,17 households accounted for 70.83%.6.Comprehensive evaluation of health service capability is in upper high level."good" range: TEUQ accounted for 16.67%,"poor" range: MXH accounted for 12.50%,two of them come from remote regions,"medium" range: 70.83% come from different cities.The main problems of rural grass-roots health centers in Ningxia are:the capability of doctors in township hospital is low,they lack of strict training and continuing education.The medical service capability of township hospital is low;Most township hospitals still have insufficient financial investment;The basic medical service capabilities and backward infrastructure construction are at low level,especially the basic equipment and equipment configuration;Lack of integration of rural health service services capability.Recommendations1.Strengthen the construction of qualified personnel in township health centers2.Strengthen investment in capital and equipment and solve the problem of unbalanced layout of township hospital3.Clarify the function of the township hospital and improve medical service capability4.To carry forward the comprehensive management efficiency of township hospital,improve the capability of integrated rural management and achieve a win-win situation for rural medical center... |
