Community Health Service Centers’ Status And The Synthetical Evaluation Research Of Its Service Function In Nanchang District

Objective:To know the service ability and the present situation of community healthservice centers in Nanchang district, comprehensive evaluation the health servicefunction of all centers, find their problems and deficiencies, and give Suggestions tothe development of the community health service centers in Nanchang district.Methods:By using the theory to preliminary set up a indication system to describe andcomprehensivly evaluate the present development of community health servicecenters;using census method to survey the basic situation,investment in health service，Policy，internal structure and financial revenues；using the relative number，meanand standard deviation to describe the current service functions of all forty eightcommunity health service centers in nanchang district, chosing the TOPSIS methodto comprehensivly evaluate its function of medical treatment、prevention、Healthcaring、rehabilitation of health、Health Education and birth control,which called “Sixin One" function.Results:1. Fundamental state:At the end of2011，there were49community healthcenters which builted according to the sub-district offices and town scope of theirjurisdiction, reaching96.08%patients of the51Planning construction centers, In2011, the government spending on health care accounted for6.74%of the averagefinancial expenditure, the per CHS special funds was1219.904million yuan in allregions, of which there was equally1074.515million yuan for the community publicehealth service,that accounted for88.08%.2. The policy:When coming to the implementation rate of national system forbasic drugs and zero marking-up policy on drug sale, the rate of the government-runcommunity health service centers who execute the policies was84.38%,the rate of thenon-government CHS centers was6.25%;the rate of the policy Merit Pay System,thecommunity first-visit system,separating the expenditure from the income and separation of clinic from pharmacy or pharmacy trusteeship in turn was83.33%、80%、0%、0%.3. Infrastructure: including the housing、equipment、beds and drugs, the businessroom area was that every center in the five districts with an average of2190.71m2,this up to standard totally,29.17%of these buildings were used for free,29.17%werethe center s own,the other39.58%were hired by the centers,and the fund forpurchasing or renting houses was from the government in42.42%centers, part fromthe government in3.03%centers,that in48.48%centers the fund was raised bythemselves;there were rehabilitation physical therapy equipment、electrocardiogrammachines glucometers and so on in most CHS centers,the least for own in the centerswas X-ray apparatuses,the rate up to60.42%; there were11.48hospital beds6.27observation beds in per centers；there were115.17kinds of Chinese medicines and262.04kinds of western medicines, each accounted for77.56%and91.20%of thenational essential drugs.4. Human Resources：of all health workers in the centers, the rate of clinicistsand nurses respectively was33.67%and35.41%,Meet the needs of1:1, in addition，the rate of traditional Chinese medicine doctors is8.79％;when going to the generalpractice team, there were0.156public health physician people per ten thousand、0.599General practitioner people per ten thousand and1.342community nurses perten thousand averagely；the rate of the clinicists that taking part in the on-the-jobtraining and the standardization training for general practitioners are41.48%and9.07％，the rate that passed the intermediate technical qualification examination forgeneral medicine majors was3.70%,40.85%of the nurses took part in thecommunity nurse job training.5. Service function:the overall leve of the "Six in One"service function wassome of low,and health care and rehabilitation services were still their weak link, theeffect of the two-way referral system was not very pleased, Although the residents’health records that Standardly documented and Computer Managing rate were high，the document information had not been used very well.6. Comprehensive evaluation:the C value of all CHS centers was generally low,the maximum value was0.469that of Taipingxiang CHS center and the minimum was0.115that of Yangzizhou CHS center; there were46centers that their C valuewas less than0.400,36centers less than0.300, the service quality in the top5wereTaipingxiang、Shanghai road、Shajing、Nangang and Chaoyangzhou CHS centers, thelast five were Taoyuan street,Tangshan street,Park street,Guangrunmen street andYangzizhou town CHS centers.Conclusion:（1）The overall coverage rate of community health service centers was good inNanchang district, but the funds for health was not balance among the centers, thebasic construction was almost completed and the focus was on public health servicesat present.（2）the centers had a good performance on Merit Pay System and thecommunity first-visit system，however，the national system for basic drugs and zeromarking-up policy on drug sale were carried out well，the policy of separating theexpenditure from the income and separation of clinic from pharmacy or pharmacytrusteeship were not adopted by all the CHS centers.（3）the housing,equipment,bedsand so on in these centers were almost meet the national requirements, nevertheless，when coming to the origining of the houses and fund, some CHS centers, owneconomic burden is overweight,and the majority didn,t have enough essential drugs.（4）there are a serious shortage of the general medical Staff，including public healthphysicians,general practitioners and community nurses,which failed to reach thenational standards.（5）The overall leve of the service function was some of low inthe CHS centers,health care and rehabilitation services were still their weak link, theeffect of the two-way referral system was not very pleased although adopted by thecenters.The residents, health records were not used in the management of maternaland the0to6years old children’s healthcare, resulting in great waste of resources.（6）The result of TOPSIS comprehensive assessment show that the overall C valueof CHS centers is low.We can set up demonstration site in the centers of the top andfind out the problems of the centers at the last,that to promote the development of allcenters.