Study On The Status And Equity Of City Community Health Service System In Guangxi

Objective To know the situation of community health service(CHS) institutions and staffing of the cities in Guangxi, and evaluate its population equity and geographical equity, reveal the problems of the institutions and staffing, explore the effective measures to perfect CHS system, provide scientific basis for government departments to work out a development plan of CHS and optimize the allocation of CHS resources.Methods This study material mainly comes from The Statistics of Guangxi CHS(Internal material, Division of Maternal and Child Health Care and Community Health, Guangxi Health Department, 2009), Guangxi Statistical Yearbook 2010(China Statistical Press), China Health Statistics Yearbook 2010(Health Ministry of PRC) and the government work report of cities in Guangxi by 2010. Evaluate population equity and geographical equity of CHS institutions and staffing by Lorenz Curve and Gini Coefficient. Use EXCEL2003 to do descriptive statistical analysis, draw Lorenz Curve and calculate Gini Coefficient.Results (1) By the end of 2009, there are 4145 CHS staff in Guangxi, including 1724 community doctors, 1671 community nurses and 750 public health physicians. (2) The degree of community doctors is mainly tertiary education and bachelor degree or above, 1421, accounts for 82.42%; the title is mainly the intermediate title and primary title, 1493, accounts for 86.60%. (3) The degree of community nurses is mainly tertiary education and secondary education or below, 1625, accounts for 97.25%; the title is mainly the intermediate title and primary title, 1556, accounts for 93.12%. (4) The degree of public health physicians is mainly tertiary education and secondary education or below, 609, accounts for 81.20%; the title is mainly the intermediate title and primary title, 634, accounts for 84.53%. (5) By the end of 2009, there are 125 CHS center in Guangxi. Held by the government, 112, accounts for 89.60%; into the range of health insurance, 109, accounts for 87.20%; to carry out the traditional Chinese medicine service, 95, accounts for 76.00%; 1,335,827 copies of health records have been established, the ratio of 32.48%; the total room area is 229,015.14 square meters, the average area is 1,832.12 square meters; the constitution of housing source: 77.60% is owned, 20.80% for the lease, 1.60% for the community free of charge. (6) By the end of 2009, there are 186 CHS station in Guangxi. Held by the government, 93, accounts for 50.00%; into the range of health insurance, 137, accounts for 73.66%; to carry out the traditional Chinese medicine service, 117, accounts for 62.90%; 567,340 copies of health records have been established, the ratio of 30.68%; the total room area is 86,606.61 square meters, the average area is 465.63 square meters; the constitution of housing source: 55.38% is owned, 42.47% for the lease, 2.15% for the community free of charge. (7) The results of equity analysis: the gini coefficient of population equity of CHS institutions, community doctors, nurses and public health physicians were 0.4168, 0.2981, 0.2905 and 0.3963; the gini coefficient of geographical equity were 0.7024, 0.6168, 0.6126 and 0.6909. Conclusions (1) The quantity of the community doctors and public health physicians are not up to national standards, the ratio of doctors and nurses is up to national standard. (2) The community doctors and nurses' degree level is better than the national average level, the overall degree level of the community doctors is significantly higher than the nurses and public health physicians. the advantage of the ratio of the community doctors with high degree is not obvious, the ratio of the community nurses with low degree is too high, the ratio of the public health physicians with high degree is too low. the ratio of the whole staff with senior title is too low, the structure of title is not too reasonable. (3) The CHS network in Guangxi is still not perfect, the coverage rate is not high; the function of CHS has no full play; the government's support should be more power. (4) Equity research shows that population equity of the institutions and staff is better than geographical equity, the equity of the institutions'distribution is lower than the staff's, the equity of the public health physicians'distribution is lower than the community doctors'and nurses'. (5) Aimed at the problems, this research suggests the following advices: intensify efforts to train the CHS talents; strengthening the government responsibility to expand the coverage of CHS; improving the function of CHS; planning the development of CHS and making a rational distribution of CHS institutions.