Research On The Quality Of Pre-Marital Health Care Service In Yunnan Province Based On Structure-Process-Result Theory

Objective(s):This study belongs to a cross-sectional study.From the perspective of suppliers and demanders,this paper understands the service status of premarital health care institutions in Yunnan Province,and analyzes the quality of premarital health care services in Yunnan Province by using the quality framework of "structure)-process)-outcome" to reveal the current situation of resource investment and business management of premarital health care institutions.This paper discusses the fairness of premarital health care service and the satisfaction of service objects and service providers,discusses the problems existing in the service process and the related factors affecting the service quality,and then puts forward opinions and suggestions on quality improvement,with a view to providing reference for Yunnan Province to formulate scientific and reasonable premarital examination policies,improving the compliance of the people’s voluntary premarital examination,meeting the diverse and multi-level needs of the people,promoting the homogeneous development of premarital examination work in Yunnan Province,narrowing the differences between regions and institutions,minimizing the occurrence of birth defects and the prevalence of infectious diseases,and at the same time,being similar to the whole country.Methods:This study reveals the structural quality of premarital health care in Yunnan province,including facilities and equipment,human resources,policy support,process quality,service flow,service items and object demand,and result quality,namely service quality,by conducting a general survey of premarital health care institutions and premarital doctors in Yunnan province and consulting the Annual Report of Maternal and Child Health in Yunnan Province from 2003 to 2020.Among them,the sampling survey adopts stratified random sampling method,and the sample size is calculated according to the current survey formula,and a total of 651 premarital examination objects are selected for questionnaire survey.Use SPSS23.0statistical software to sort out and analyze the data.Statistical analysis method:descriptive analysis is used in quantitative investigation to analyze the frequency distribution and percentage of data;T/F test was used in univariate analysis,and logistic regression and stepwise regression were used in multivariate analysis to analyze related indicators and influencing factors,with a difference of P<0.05.Results:Structural quality: There are some problems in pre-marital health care institutions in Yunnan province,such as nonstandard infrastructure construction and facilities and equipment,unreasonable structure of pre-marital doctors,and different subsidy standards for pre-marital medical expenses in different regions.Process quality: Although most institutions have carried out premarital health care services in accordance with the Code for Premarital Health Care(Revised),there are still some problems in the process of service development,such as complicated service process,incomplete service items,lack of health education,and neglect of premarital health guidance and consultation.Results Quality: In 2021,the premarital check-up rate in Yunnan Province was91.77%,which was in the forefront of the country,and the disease detection rate was8.92%,which was higher than the national level.The utilization fairness of premarital check-up services in different regions showed a trend of gradual balance,but the job satisfaction of premarital check-up doctors was low.The overall score of job satisfaction of premarital check-up doctors in Yunnan Province was(3.85 0.64),which was at the general level.The last five with the lowest satisfaction rate are "promotion opportunity of this job","my remuneration and my workload","working conditions","the opportunity to play an important role in the team" and "the opportunity to do different things from time to time".The job satisfaction scores of premarital doctors with different working institutions,professional titles,majors,working methods(full-time/part-time)and salaries are statistically significant.The overall satisfaction score of premarital examination clients is 4.74 0.50,which is between satisfactory and very satisfactory,and the overall satisfaction rate is 94.01%.The overall satisfaction is related to the institutional environment,the technical level of premarital examination doctors and service attitude,among which the institutional environment and service attitude have great influence on the overall satisfaction of premarital examination clients.Conclusion(s):1.The premarital health care in Yunnan Province has made some achievements:the premarital check-up rate has risen and is in the forefront of the country,the fairness of the utilization of premarital check-up services in various regions has gradually become balanced,and the satisfaction of the clients of premarital check-up services is high.2.2.At present,there are some problems in pre-marital health care institutions in Yunnan province,such as poor convenience,hardware facilities and services to be standardized,pre-marital health care subsidies to be standardized,pre-marital health care publicity not in place,the structure and comprehensive quality of pre-marital doctors to be improved,and low job satisfaction of pre-marital doctors.3.In order to improve the quality of premarital health care service in Yunnan Province,the following suggestions are put forward: popularizing "one-stop" premarital health care service,clarifying the fund-raising standard of premarital health care,standardizing the organization construction,strengthening the publicity of premarital health care by multi-departments,improving the people’s cognitive level,strengthening the construction of premarital doctors,establishing and improving the incentive mechanism,etc.