Research On The Impact Of County Medical Alliance On The Service Quality Of Primary Health Care Institutions

ObjectivesOn the basis of typical case,this research is conducted to analyze the impact of County Medical Alliance on the service quality of primary healthcare institutions,applying the Structure-Process-Outcome model.By investigating the key influential factors,this thesis aims to support suggestions on the improvement of the service quality of primary healthcare institutions,the promotion of county health system integration and the implementation of hierarchical medical system.ContentsBy summarizing the status in practice of the construction of County Medical Alliance in Zhijiang County of Hubei province,to induce the key elements and links that may affect the quality of primary health care services.Based on the Structure-Process-Outcome model to compare the impact of County Medical Alliance on the service quality of primary healthcare institutions.Putting forward policy suggestions for the promotion of County Medical Alliance in our country.MethodsQualitative and quantitative research were adopted in this study.Investigation in typical area,mainly by interview and questionnaire surveys,is used to collect related materials.Primary healthcare quality service Assessment ToolAdult Edition(PCAT-AE)was used to assess the service quality of primary healthcare institutions.The quantitative data was collected by exit review,and from health administrative department,primary healthcare institutions.Quantitative data were analyzed by descriptive statistics,while qualitative data were analyzed by thematic framework analysis.Findings1.The main content of integration:In terms of governance mechanism,several government departments participate in the governance of County medical alliance under the leadership of the government.And it also established a board of directors and supervisors in the form of multiple legal entities.In terms of organization management,it established a unified talent management mechanism,evaluation mechanism and also built a unified medical information platform.In terms of medical service providing,the division of responsibilities of each member has been defined,and the homogenization management of medical quality has been promoted.In terms of financing and payment mechanism,it took Provider payment reforms and setted Capitation under the budget cap.2.At first,the resource utilization efficiency of primary healthcare institutions has been increased.Second,the capacity of primary healthcare institutions to provide hospitalization services has been improved.Third,the income and expenditure of primary healthcare institutions has been increasing and its composition becomes more reasonable.Fourth,the basic public health services have not been weakened.Fifth,the functional orientation of primary healthcare institutions remains unchanged,and the comprehensive degree of service is relatively high.3.The existing deficiency and problems:Firstly,the siphon effect is still existing.secondly,the first visit accessibility and service coordination need to be strengthened.Thirdly,the vertical two-way flow of talent is difficult to solve the problem of personnel loss and shortage.Fourthly,there is lacking of incentive mechanism.Fifthly,the sharing of regional medical resources is at a low level.SuggestionsTo further promote the construction of County medical alliance and develop the quality of primary care services,the following suggestions are proposed:firstly,comprehensive solution such as the construction of departments with characteristic and internal and external performance assessment and so on should be taken to alleviate the siphon effect.Secondly,the construction of primary healthcare institutions' talents should be further strengthened through innovating and standardizing the mechanism of employing in County medical alliance.Thirdly,it should improve the mechanism of benefit distribution to strengthen the technical cooperation between county and township medical institutions.Fourthly,to improve the coordination of primary health services,the referral standards should be more standardized.At last,through promoting the regional medical and health resources sharing,to improve the level the homogenization of regional medical services.