Research In Model Of Interaction Mechanism Of Rural Health Service Netwok Based On The Continuity Of The Service

[Purpose]The purpose of this study is to analyze the characteristics of rural health service institutions,interpersonal,information continuity and its influencing factors,and to find out the mechanism of the continuity of health services.On this basis,combined with the regional health conditions,health care reform measures and policy guidance,to promote the construction of rural grassroots health service continuity model.[Methods]Literature analysis was used to search database query to analyse the concept of health service continuity and summarize the research methods.We used questionnaire survey and extracted information of visit service from county hospitals,township hospitals and village clinics.In theoretical research,stakeholder analysis,interaction mechanism research and IDEF0 model were used.[Results]1.The medical institutions of rural residents first diagnosed village health room the highest proportion(42%).The impact of rural residents’ choice of medical institution factors of the "severity","accessibility","medical level" and so on.There are large differences in mean volatility,fluctuations in the range of 3.94 ~ 12.17.The area,age group,chronic diseases and health status have influence on health service utilization.(P<0.05).2.The UPC score showed a skewed distribution,and the people whose score of UPC above 0.2 is more than 97%.The COC index score of 33.68% of the patients was 1.People in different areas of health service interpersonal continuity dispersion had significant difference(P<0.05),and the dispersion of the scores in different treatment times under were at a high level.The SECON score which fell in the proportion of 0~0.2 is below 3.30% and of above 0.5 is below 17.06%.3.The continuity of information of residents in rural areas of China55.6% of patients indicated that they did not have the habit of taking care of the medical records of the patients before the doctor and the doctor in charge and 52.8% of patients responded the doctor asked.52.7% of the patients said they would find the same doctor every time they visited the same medical institution.4.Village doctors in the initiative to understand the health status of patients and bad habits and other information as high as 98.32%.There are more than 80% of village and conty doctors to understand the status of their families,work background.68.57%of medical staff at the county level pay more attention to the exchange between peers.71.43% of the medical staff at the county level indicated that they were familiar with the medical staff at the upper and lower levels.More than 94% of the county level,village level medical staff said there is a certain business communication and business training.[ Conclusions]From the perspective of institutional continuity,resource distribution of medical institutions in rural areas is not balanced position on their own lack of continuity between medical institutions,medical institutions at all levels of the organization still has many shortcomings,especially in township hospitals and between the upper and lower medical institutions,personnel,information exchange and related business still need to strengthen the training,to ensure the implementation and improvement of the two-way referral system and cooperative medical system.From the perspective of interpersonal continuity,the main object of the rural residents to establish doctor-patient communication is the primary health service providers,especially rural doctors,and the continuity of interpersonal continuity is longer,but the quality is limited.According to the degree of dispersion,the degree of dispersion and the degree of order,the continuity of health services is at a high level,but the process and habits of rural residents still need to be further improved.From the perspective of information continuity,information between between doctors and medical institutions at all levels of the continuous obstacles,lack of information communication between doctors and patients,medical information infrastructure,information platform interoperability and referral information can not be fully realized.Therefore,we should establish the perfect three rural health service network from the macro and micro aspects,strengthen the financing mechanism and performance incentive mechanism from the macroscopic perspective,policy coordination and institutional framework,regional residents demand for rational allocation of resources based on the health insurance sector to the comprehensive design of financing and payment,in addition,supervision and evaluation the establishment of a system of multidimensional.At the micro level,to establish procurement,evaluation and supervision mechanism,establish management information collection mechanism and disease management,case study,cooperative mechanism of multidisciplinary team care.