| Objective :Township health centers are important chains of healthcare system in rural area of China. " technology demonstration and product development in different types of township hospitals" was a key project of "Eleventh Five-Year" National Technology Support Programs. The aim of the project was to develop equipments, pharmaceutical logistics , information and the other key products suitable for rural hospitals. The project selected 20 hospital in less developed regions, moderately developed areas and developed regions in the country, to construct the model institutions of township hospitals of basic, general and well-off types . Xibaipo town is located in Shijiazhuang Pingshan , Hebei province ,is one of the five sacred place of revolution. The township health center located in the centre of the Xibaipo town, service population was 6,100, is a typical of "basic type" township hospital, is one of the selected 20 hospitals.In this study ,we investigated the Xibaipo residents, staff hospitals and rural doctors to learn the situation of residents'demand and utilizations of health service and the health service of township health center . In the basis of baseline survey results, combined with relevant national policies, regulations, developed construction standards of health centers, and demonstrated in accordance with construction standard.Method :(1) Literature review : Access to relevant literature and the national, provincial and municipal documents, provide the basis for investigation and developing construction standards of health centers.(2) Exchange of experiences: Communicated with other hospitals in the project , learn their design ideas and methods of setting standards. Applied the research products of three technical support teams . (3) Baseline survey: We conducted the survey which using questionnaires to collect the information of all residents in Xibaipo town. We investigated all Health Center staff and doctors in Village. The major contents included: resident health status, health service needs and utilization, infrastructures and health service delivery of the health center, health human resources, etc . All the data collected by the pre-trained staff. Delphi6.0, access was used to input data , SPSS17.0 was used for data analysis.Result:(1) Baseline surveyA: The health center's situation before the implementation of projectConstruction area was 832 square meters, with 8 wards, 24 beds, an Operating room, a delivery room. It set up internal medicine, surgery, gynecology, pediatrics, medicine, radiology, B-room, ECG room, laboratories, pharmacies and other departments. And it had device of X-ray machine , picture viewer, B ultrasound, ECG, blood analyzers and oxygen bottles each one . Can carry out surgery : debridement , limb fractures, appendicitis, varicose veins, hemorrhoids, fistula, hernia, normal delivery。The outpatient amounted to 4213 , inpatient amounted to 412,and the total income was 60 million, expenditure was 60 million, in Year 2009.B: The survey on residentsWe investigated a total of 3909 people , the results showed :①The situation of participation of NCMS is good: The participation rate of the new rural cooperative medical care (NCMS) was 98.06%, satisfaction reached 70.26%;②The health services situation was'high need ,low-use'. Two-week prevalence rate(178.82‰) and prevalence of chronic diseases (188.80‰), were higher than the national rural average (17.7%, 17.1%), the two-week consultation rate(9.29%)and admission rate (3.66%)were lower than the national rural average (15.2%, 6.8%).③Spectrum of disease: analyzed by system, the first two are circulatory diseases and muscle, bone connective tissue disease in both two-week prevalence rate and prevalence of chronic diseases. Analyzed by disease, the top 3 diseases were cerebrovascular disease, hypertension, heart disease, belong to the circulatory system diseases.④Residents were satisfied with health center: Most residents choose rural hospital as the hospital to visits and hospitalization. "Not satisfied" and only 5.54% in the evaluation of health center.⑤There was a great demand for periodic physical examination and health education.C: The survey on township health Center staff①Insufficient number of health center staff: There are only 14 health personnel, 13 medical workers, below the national level (30, 21).②The situation of the personnel allocation is irrational: professional structure was irrational, the educational level was low, the titles level was low.D: The survey on Village health workers①The quality of rural doctors is low (90.91% are non-formal school graduation), and most were part-time .②Health resources in village are scarce: 16 villages have only a total of 10 village clinics, 5 beds.(2) The standard of construction of the township health centerA: Staffing: set the total number of hospitals, the titles, all professionals.B: Beds, departments and building area: set 31 beds, additional maternal and child health, immunization room, health education room, Information Section and other 13 sections.The total area is 1705m~2, set the different sections area.C: Basic device configuration: the basic equipment for the common disease first aid, treatment .D: Health care system:①Building of farmers'healthy system: make the object and the items clearly, use the same place and time for physical examination .②Establish chronic disease management system .E: Information construction: establish the medical management system on the basis of "electronic medical record" , establish the public health services and health management information system on the basis of "health record" .F: Telemedicine system: Purchase of necessary equipment to make remote video consultations, remote consultations for difficult and acute disease, and remote training.(3) The construction situation of the health centerNew building area is 1800 m2, cottage area is 300 m2 , allocation of functional areas and departments set more reasonable. Health center add 19 new devices using the research funds, state funds which support the old liberated areas, and other project funding .There are more than 660 drug in pharmacy, equipments and materials for emergency treatment. The health prevention system has built up, the rate of health Record filing is up to 60%. Integrated management system of towns and villages is build up. It has established cooperative relations with the large general hospitals. Information technology and telemedicine system has not yet completed.Conclusion:(1) We conducted a baseline survey of health services in the town of Xibaipo in Hebei province , so as to provide baseline data for the establishment of a "basic type" rural hospital's comprehensive model.(2) We set the standards construction standards of the township health center at respect of Staff, departments, building, etc.(3) The current situation of the construction of technology integration demonstration in township Health Center of Xibaipo is good .(4) In the the new situation of "big Xibaipo construction", there is both opportunities and challenges of the construction of the demonstration in Xibaipo township health center . |
PDF Full Text Request