Research On The Medical Service Ability Of Rural Area Hospital Staff At Three-level Medical Institutions In Xinjiang

Objective: The study gained the understanding of the current situation of the personnelresource allocation, service ability of medical staff and public health service ability at thehospitals in three-level medical system in rural area in Xinjiang; through theunderstanding of the condition of training, staffs’ familiarity with the professionalknowledge and their patients’ satisfaction to explore the underlying factors that affect thequality of their medical service and put forward the suggestions for the improvement.Method: Stratified random sampling was adapted to select6improvised counties out of36, and conducted a survey on medical service ability in6country hospitals,46hospitalsin town and508village clinics. Meanwhile, questionnaires were distributed to staff to testthe professional knowledge, training expectations and local residents’ comments on thelocal medical services, and all data were analyzed by SPSS17.0. the qualitative data wascollected by interviewing the chiefs of the local Health Bearu, directors the all hospitalsand village doctors, and then all content was analyzed by content induction.Results:(1) the current situation of the personnel resource allocation: the county,township and village medical personel’s education background mainly made up bytechnical secondary education, which takes up46.11%,69.09%and46.77%respectively;the title of the technical post mainly is junior title, county hospital has60.73%, andtownship has55.81%; most of the medical personel are majored in clinical medicine andnurse; for the mobility, staff who hold junior title transfer most in county hospital, whichinflow takes60.90%and outflow takes37.65%, none title post flows in most in townshiphospital, meanwhile the junior flows out most; the mobility of technical secondaryeducation background and health technical personel are more than others.(2) for thetraining and further study: most of the staff take training in specialties, and65.05%county hospital staff take training in municipal health organization, and65.77%township stafftrained in same level hospitals,95.34%village clinic doctors get training in township levelmedical institutions.(3) for the training expectations and familiarity of the professionknowledge: the medical staff of county and township hospital mainly master in internalmedicine, surgery, gynaecology, while the staff in county hospital are not so familiar withpublic health knowledge, and township hospital personel with some basic medicine andresearch knowledge; the respondent doctors mainly want to get trained in internalmedicine, surgery, emergency and pediatrics. Nurses in both hospitals grasp theknowledge well in common disease nursing, emergency nursing and chronic diseasenursing, and weak in the prevention and control in psychosis, traditional Chinese medicinenursing, and gerocomy; the respondent nurses are willing to get trained in emergencynursing, common disease nursing chronic disease nursing and infectious disease nursing,but low expectation in training terminal care, communication skills, psychosis healthmanagement and prevention and management in common disease.(4) the quantity ofservice increases every year, county hospital treat emergency cases most, which takes up85.63%of the total service, and the outpatient treatment of township hospital is most,which account for67.17%, the improvement rate of inpatients are above50%; for thequality and capacity of the service, the setting rate of profession department of countyhospital is high in cardiovascular, respiratory and hemadenology, which is98.15%,96.67%and83.33respectively; the average rate of surgery setting is38.12%, the serviceitem mainly focus on the orthopedics, especially chest surgery. For the township hospitals,the service carried out well in internal medicine, shows91.30%, and followed withprevention and health section, gynecology, while stomatology and dermatology are poor inservicing; induced abortion operates more than other surgery operation, which is26.09%;for the diagnosis, electrocardiography operates well, the rate accounts for80.43%; andmost of the staff can do hemostasis, wound dressing and healing; the work of infectiousdisease reporting is best among all the public health service.(5) The satisfaction of thepatients towards the medical personel shows highest in county hospital, and then intownship hospital, lowest in village clinic, which average rate is67.88%,66.73%and40.2%, the safety of diagnosis and treatment is the first and most important index for thepatient to choose the health care institution.Conclusion (1) Government should make some polices and provides some benefits inorder to increase the numbers of the qualified medical practitioners and make them stay inrural or poverty area; and make efforts in encouraging those who haven’t got the medical practitioner license to pass the exam.(2) Give great play to the information technology,enhance the continuing education, and attach importance to the disease prevention,improve the public health service ability, to adopt different ways to improve the basicmedical treatment skills and diagnosis.(3) Pay attention to the medical education in ruralareas, enhance the ethnic folk medicine.(4) Make full use of clinic practical training toimprove the general practitioners service ability.(5) Complete the training system, toencourage the staff self-study through the performance assessment.