| Objective: This study selected 267 township health centers(THCs)of 12 counties from three regions of Eastern,central and Western during 2015 year as the research object.Using the diseases information and the database information in THC to clarify the types of diseases can be admitted in THC,understand the actual diagnosis and treatment level of THC,and explore the non-individual factors influencing people choose the THC to treat,in order to provide the clues for guide residents to treat reasonably,and control the increase of medical cost reasonably.Methods: With the Health Planning Commission’s assistance of the sample Province,data collection was carried out by sending out questionnaires through e-mail.And the relevant data of THCs in 2015 were collected and database was established.Through literature review,the theoretical basis of the study was established.Basing on the panel discussion and expert consultation,we established the research plan.By the use of questionnaire survey,comparative analysis,multivariate linear regression analysis,the diseases admitted in rural THC,the diagnosis and treatment level of THC at the present stage,and the factors influencing rural residents choose THC to treat were analyzed.Results:(1)There are 14 species of disease admitted in the eastern and central areas’ THC,and 13 species of disease in the western region.The top five diseases admitted in THC in the eastern sample area were respiratory system diseases,circulatory system diseases,pregnancy,childbirth and puerperium,digestive system diseases and injuries,poisoning and external causes.The top five diseases admitted in THC in the central sample area were circulatory system disease,respiratory system disease,digestive system disease,musculoskeletal system and connective tissue disease and pregnancy,childbirth and puerperium.The top five diseases admitted in THC in the western sample area were respiratory diseases,musculoskeletal and connective tissue diseases,circulatory system diseases,digestive system diseases and mental andbehavioral disorders.The number of types of diseases from three regions and rank of inpatients are not the same,there is a big difference between areas of the disease admitted in THC.(2)In the average hospitalization expenses,the residents spend in the eastern sample area was 1.94 times than middle sample area,which was also 2.48 times than the Western sample area.(3)More than 50% of the THCs in the eastern sample area can treat the respiratory system diseases,circulatory system diseases and digestive system diseases.In the middle and Western sample areas,more than 60%THCs can treat three kinds of systemic diseases.However,in addition to the above three systemic diseases,there are four types of diseases in the eastern region where the proportion of institutions is more than 20%,while there are only three types in the central and western regions.Overall,township health centers in the eastern sample area have a more balanced treatment of common diseases.(4)In terms of health staffing,the proportion of middle and above professional titles in THCs in the eastern sample area(48.19%)is significantly higher than that in the central region(27.54%)and the Western sample area(20.43%).In addition,the number of health personnel,number of health technicians,number of practicing(assistant)physicians,number of pharmacy personnel,and number of medical technicians in the health facilities of township health centers in the eastern sample area are higher than the national average.The number of practicing(assistant)physicians,the number of pharmacy personnel,and the number of medical technicians in the health staffing of township health centers in the central sample area is higher than the national average.In the western sample area,only the number of pharmacy personnel is higher than the national average,and the remaining items are all lower than the national level.From this we can see that in the eastern sample area,the proportion of middle and above professional titles in THCs are higher than that in the central and western sample areas,and the number of health personnel in each institution is also better than that in the central and western sample areas.(5)In the setting of departments,whether it is a single department or a combination of department,department settings of THC in eastern sample area were relatively complete,and the central and western sample regions were more perfect only in some departments,and some departments closelyrelated to the diagnosis and treatment of common diseases and chronic diseases were inadequate,such as department of traditional Chinese medicine,pediatrics and so on.(6)The factors influencing residents choose THC to treat in rural area were the number of the functional departments,the number of physicians,the number of middle and above professional titles,the distance from the county hospitals,the per capita income of residents and township financial revenue.Among them,the number of functional departments,the number of physicians,the number of middle and above professional titles,the distance from the county,the financial income of towns are positively related to the tendency of residents to choose the township health center for medical treatment,and the per capita income of residents and the tendency of residents to choose the township health center for medical treatment is a negative correlation.Conclusion: As the main providers of primary medical services,township health center are important points for promoting the development of a hierarchical medical treatment system.Through the analysis and summary of this paper,we have learned that there are differences in the scope and types of services of township health centers in different sample areas,and township health centers in the eastern sample area are superior to those in the central and western regions in terms of the proportion of middle and above professional titles and the number of health staff in the hospital.In the department setting,township health centers in the eastern sample area are also more balanced in the establishment of departments.Through multiple analysis,it was found that non-personal factors such as the number of functional departments,number of physicians,number of middle and above professional titles,distance from the county,per capita income of the residents,and financial revenue of township health center have certain influence on the tendency of residents in rural areas to choose township health centers for medical treatment.Through the promotion of construction of the medical association,increase their own rights of employment of medical institutions,build and perfect department of township health center,increase financial investment,improve the rural infrastructure construction and other relevant policies and measures to prompt residents to develop good habits about treatment,which willbe conducive to meet the basic medical needs of residents in rural areas,more conducive to promote the early realization of hierarchical medical treatment pattern. |
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