| With the opening and reform, China's government follows the leading principle of economic construction as its work's center promoting the rapid progress and development of economy. But on the other hand, with the rapid growth of economy, little attention is paid to the functions of social management and public services, which causes numerous social problems and increasing affects the continuous, moderate and healthy progress of economy. The city community service is a grass roots organization that takes the people's health as its center, people's health need as its guide. The development of the city community health service not only can raise the equity and efficiency of the health service, but can control the unreasonable growth of the medical treatment expenses as well to raise the residents' healthy level. The development of the city community service is the urgent demand for solving the existing problem of "seeing a doctor is difficult as well as expensive."the efficient short cut to keep its system structure in balance, the intrinsic need for carrying out the work policy of "prevention for lord"and strengthening the public hygiene system construction, the basic path for adapting the disease family change and for everyone to possess the equal right for health care, the urgent request for building up the towns and cities residents'medical treatment insurance system, the effective measures to enrich the contents of the city community construction , ensure the nation to develop in a stable and prosperous way. The development of the city community service in Jilin Province is grouped into three stages since 1998: trial stage, popularity stage and widespread stage, which promote the establishment of framework of the city community health service. Under such circumstance, the city community health service is gradually perfect, the talented persons'qualities are further enhanced, management is standardized step by step, and the exterior development environment is optimized with the time going. But in the process of the city community service, there appear some difficulties and problems that seriously prevent the healthy development of the city community health service in Jilin Province. These difficulties and problems are reflected in the following aspects: firstly, the lack of management functions and performance in the all levels government causes the financial insufficiency on the public community health service, the development structure of government predominance and the related sectors participation in the field of the city community health service has not made yet, concerned policies have not been carried out effectively; secondly, the city community health service system is not agreeable, further explained, the sectors responsible for the community health management function switch multifariously and unstably, the city community health service system is not sound, the operation mechanism goes with troubles; thirdly, the city community health service functions are not perfect, to be in details: the healthy education of community becomes formalistic, the community prevention and health care functions are needed to be improved, the service forms remain unchanged, the systematic management and recovery in the fields of the treatment of chronic disease don't appear yet; fourthly, the source of the talented persons for the city community health is not sufficient, the main performances are as follows: the service and management staffs are not enough, the whole section medical foundation theories lack, the general practitioner is short, the community medical personnel's basic and technical knowledge level needs to be exalted; fifthly, the legal system constructions in the city community health service are seriously laid behind ,the policies on the community health service have no law to abide by in time, the kit laws and the professional standardization construction don't follow the pace of the its development, the service contents and the service forms lack the legal support, the entry policy for the city community health service in Jilin Province is not explicit, the lack of the inspection and supervision staffs with regard to the city community health service makes it impossible to maintain the work constant and regular. To push forward the development of the city community health service in Jilin Province, the most important of all, the local government must make a clear definition about its functional roles in the city community healthservice. The first, divide the city community health service items reasonably. The city community health service, according to whether exclusive or non-competitive, is fallen into three types: namely: public hygiene service item, precise public hygiene service item, private health service item. The second, the government duties are determined by the categories. The public items should be provided by the government-run medical treatment organizations or the nonprofit medical treatment organization by way of the social capital contract represented by the government, the public health service items are partly purchased or provided by the government according to financial power of the local government, partly by the residents according to the market principle; to the private health service items, among them the basic hygiene items are purchased by the residents according to the market principle, the government provides the subsidy to the disabled people, non basic hygiene items should be provided by the residents according to the marker principle. The third, all the nation's sustaining policies should be carried out down to the ground, which includes the establishment and the perfection of the public financial guarantee mechanism, improving the health budget structure, increasing the new investments on the city community health service. The fourth, introduce the social capital actively on the basis of insisting on the government's leading role in the urban community health service, and set up the diversified city community health service investment system. The fifth, enlarge the publicity strength of the city community health service and construct the exterior environment advantageous to the city community health service development. The next in order, adjust the management system in the city community health service. The first, make the administrative functions of the related sectors clear, that is to say, regulate the development programs for the city community health service and carry on the industry entry procedures and the professional training on the technical staffs, draw up and optimize the industry technique standards, insure the harmonious relationship between the governmental order and the practical work, draft the related law and codes according to corresponding administrative functions in order to supervise the work in the community health service or entrust the work to the peer unit.The second, the city community service system should be established by the following steps: quicken the network construction of the city community health service, gradually take the community health service station as the net bottom, the community health service center as the pivot, the prevention medical care organizations, large comprehensive hospitals as well as the specialty hospitals as its technical support. The third, optimize the city community health service mechanism. Strengthen the entry mechanism in the city community health service, found the finance guarantee mechanism for the city community health service, optimize and establish the mechanism for the evaluation and encouragement in the city community health service system, optimize the training mechanism in the city community health service system, set up the two-way treatment mechanism. More further, improve the method and means of the city community health service's management. The first, speed up the steps of legalization construction and regulations of laws and codes in the city community health service, build up the specialized staffs to supervise the health service work, enlarge and strengthen the supervision of the health behaviors in the city community services. The second, make full use of the market's positive roles in installing the community health resources, combine the functions of government control and market regulation together in terms of the health resources distribution, promote the strategic adjustment to city health resource structure, lead the city health resources to flow to the basic levels and attract more social capitals to serve the community health service by means of policy leading, program establishment and economic regulation. The detail information release will guide more and more residents to understand the city community health service cultivating the birth of the city community health service city. The third, strengthen the supervision of the city community health service, frame the fair and orderly city community health service environment. The fourth, strengthen the supervision power of administrative enforcement, bring the development of the city community health service into the yearly work target of all the levels government or the real fact engineering, set up different systems, such as: community health service joint meeting system, check system and responsibility investigation... |
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