| Objective: Through a combination of vertical（2009-2018）and horizontal（North,Central,and South Anhui）collection of basic public health service-related data and data analysis,a comprehensive grasp of the basic public health service policy development in Anhui Province from 2009 to 2018,health resources,service supply,residents’ service utilization and satisfaction,etc.,and combined with the interview content of key insiders,summarize the problems and obstacles that affect the implementation of basic public health services in Anhui Province,and propose optimization strategies in a targeted manner.The first stage provides the basis for adjusting relevant policies and improving service quality.Methods: Based on literature research,12 sample districts/counties were selected in northern,central and southern Anhui using multi-stage intentional sampling,and went to sample sites for research from December 2019 to February 2020,and collected basic data from 2009 to 2018.Implementation of public health service projects.During the research process,a questionnaire survey and insider interviews were conducted among the persons in charge of basic public health and the residents receiving services in the sample areas.Descriptive analysis,multiple linear regression,TOPSIS method and rank sum ratio method were used for data analysis.Results:（1）The basic situation of population and health resources in Anhui Province.From 2009 to 2018,the overall population of permanent residents in Anhui Province did not change much,and the registered population increased significantly.The number of urban community health service centers and community health service stations has grown significantly,and the number of institutions and personnel in township health centers and village clinics has been declining year by year since 2013.In terms of capital investment,the subsidy standard for per capital basic public health services in Anhui Province has been increased from 15 yuan in 2009 to 55 yuan in2018,and the total investment in project funds has also increased year by year,with a slight decrease from 2015 to 2018.In terms of fund allocation,the allocation of funds for basic public health service projects from scratch has become more and more standardized,but the interval is relatively long,and the situation in each region is quite different,which may affect the development of related work to a certain extent.（2）Analysis of policies related to basic public health services in Anhui Province.During the ten years from 2009 to 2018,when the basic public health service project was implemented,Anhui Province has successively issued dozens of documents of various types.In terms of assessment and other aspects,the project operation mechanism has been gradually improved.（3）The development of basic public health service projects in Anhui Province from2009 to 2018.From 2009 to 2018,the completion rate of each indicator in the sample areas of Anhui Province basically showed an upward trend year by year.In 2018,the completion rate of each indicator in the sample areas of Anhui Province was45%～100%,basically reaching the national standard level,and the project effect was relatively high.Good,but there are large differences in service quality between regions and between urban and rural areas.The central and southern Anhui regions are generally better than the northern Anhui regions,and the quality of basic public health services in cities is generally better than that in townships.（4）Resident benefits and satisfaction.A total of 787 urban and rural residents were surveyed,including 471 elderly people aged 65 and above,267 patients with chronic diseases,42 parents of children aged 0-6,5 pregnant women,and 3 family members or guardians of patients with severe mental disorders.The results show that the proportion of residents obtaining the required items is 60%-84.2%,and the satisfaction level in the dimensions of basic public health service effectiveness,trust,convenience,and tangibility is 90%,and the service utilization rate and satisfaction level are all 90%.higher.Conclusion: In the past ten years,the implementation of basic public health service projects in Anhui Province has achieved good results,and various indicators have basically reached the national basic public health service task goals,and residents have a high degree of satisfaction and sense of achievement.However,from the survey results of the sample areas,there are still problems such as insufficient personnel and equipment in primary health institutions,large differences between regions,long time limit for service project adjustment,insufficient participation of professional public health institutions,and insufficient project publicity and policy advocacy.,it is recommended to attach importance to the training of public health personnel,increase investment in disadvantaged areas,give grassroots health institutions autonomy in the use of funds,expand project revenue,make efforts from multiple departments,improve the comprehensive capabilities of grassroots health service institutions,increase project publicity,and improve the sense of project acquisition. |
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