Study Of Effectiveness Evaluation And Capability Of The Health Service Of The Community Health Services In Jiujiang City

Objective:To understand the health service capacity and service effect of the communityhealth service institutions in Jiujiang city, and discover the problems in theimplementation process of health service of community health service institutions,and provide a reference for the formulation of relevant health policy by investigating,collecting, sorting and analyzing data.Methods:In this study, we made the registration form and questionnaire throughconsulting documents, and sampled the community health service institutions bystratified sampling combination with random sampling, and surveyed the communityresidents by using random sampling, intercept and home interview, and described theservice institution capability by using the method of description and analysis, andacquire the weights of evaluation factors of residential satisfaction through expertconsultation method. In addition, we used the method of TOPSIS to comprehensivelyevaluate the service effects of the health service of community health serviceinstitutions in Jiujiang city based on the community residents’ satisfaction.Results:(1) We investigated20health service agencies (centers5, stations15) in Jiujiangcommunity, including3centers and9stations in Xunyang District and Mount Ludistrict as well as1center and3stations in Development Zone.3023residents weresurveyed.1726were from Xunyang District which accounted for57.10%and653were from Mount Lu District which accounted for21.60%and644were fromDevelopment Zone which accounted for21.30%.(2) In the investigation institutions, the total numbers of employees were354people, including189in the centers (accounted for53.39%) and165in the stations(accounted for46.61%). The total numbers of health technical personnel were291people (accounted for81.64%) and the ratio of doctor and nurse was1:0.82. Theeducation backgrounds of the staff were given priority to with junior college and technical secondary school and below, which accounted for76.82%. The generaltraining accounted for30.45%and intermediate technical qualification examinationpass rate was29.73%(Pass rate=the mid-level technical qualification examinationpassed number in2012/the total number of participating in the test in2012).(3) Community health service centers should possess the seven kinds ofnecessary equipment, such as rehabilitation physiotherapy equipment,electrocardiogram (ECG), blood glucose monitors, biochemical analyzer, Bultrasound, centrifuge, X-rays machine and community health service stations shouldhave the five kinds of essential equipment including ECG, blood glucose meter,rehabilitation physical therapy equipment, health education video system, computeraccording to the standard health agency set up of national city and community. All ofthe community health service centers in our study had the necessary equipment withthe ownership rate of100%(Except for White Lake Center without X-rays machine)and the ownership rate of stations was96%. The qualified rates of business roomareas of both center and station were100%. Business premises from rentingaccounted for75%and the business areas from purchase took up4%. In addition,there were5%from free. Business houses were got by purchase or rental. As to therent, it was mainly from self-financing, which accounted for75%, and provided bygovernment institutions with only5%.(4) All agencies were carried out free medical services. The resident filing ratewas79.56%. Institutions carried out health education with an annual average of13.65times and the average numbers of attendance for each time were73.90%of theinstitutions carried out vaccination services. Community children vaccination ratewas93.47%. Pregnant woman health rate was75.07%. The prenatal examinationproportion was86.30%and the postpartum visit rate was22.01%. The rate of chronicdisease visit was68.34%and patients with the supervision from treatment agenciestook up79.91%patients. The rat of accepting rehabilitation service was72.42%.There were95%of the institutions which provided the service of family planning andtechnology guidance.(5) Residents awareness rate for community health service was as high as97.25%.83.85%of residents believed that the distance from home to agency was within20minutes, suggesting good convenient for the institution. The proportion thatresidents with ailment would like to take community health service institutions as thefirst hospital was72.71%. Respiratory disease accounted for the largest proportion inclinical disease types of institutions, which was51.90%. In recent one year, the ratethat patients visited the community health services institutions for5times and morethan5times was the largest, which was46.18%.(6)The highest degree of satisfaction was in the waiting time. The rate ofsatisfied and very satisfied was89.95%, ranking the lag two in the diagnosis andtreatment level (the ratio of good and very good together was23.83%) and nursingtechnique (the ratio of combination very good and good was40.78%).(7) TOPSIS results showed that Mount Lu area possessed the highest degree ofsatisfaction in the areas and the resident satisfaction in the stations was higher thanthat of in the centers.Conclusions:(1)Human resources in the agencies were poor. The total number of staff wasless and the average was18in each institution. Most of the staff had the collegeeducation background with primary title and its overall level was low. As to the rateof the job training, doctors accounted for32.91%and nurses accounted for37.48%with the pass rate of29.73%, which was smaller.(2) As to institution construction, the owning rate for necessary equipmentprovided by the Ministry of health was100%in the center and96%in station. Therates of reaching standard for the areas of business houses were100%in both centerand station.(3) Service provision and utilization situation were good. The residentawareness rate was84.32%and the number of people with ailment preferred thecommunity health service institutions accounted for72.71%.(4) It is higher to resident satisfaction, which reached81.21%，but the level ofdiagnosis and treatment (23.81%) and nursing technique (40.78%) is lower thanothers.(5) The degree of satisfaction was higher in the residents of Mount Lu area thanthat of the other two administrative regions. The degree of satisfaction was higher in the residents of community health service station than that of the community healthservice center.(6) It was better in the hardware of the organizations (such as equipment outfit,business premises and so on) than software which had space for promotion (such asstaff qualifications, titles and so on).