The Current Situation Of Public Health Services In Public Hospitals In Anhui Province And Their Improvement Strategy Study

Objective This study investigated the current situation of public health services in public hospitals in Anhui Province and the awareness of public health among medical personnel and the factors influencing public health in hospitals in a sample of public hospitals in Anhui Province.The aim is to provide reference for governmental departments to formulate relevant development strategies and support policies,and to promote the integration of health care and prevention.Methods We used literature analysis to understand the current patterns and status of public health development in public hospitals at home and abroad,systematically sorted out the policy documents related to public health services in public hospitals issued at the national and provincial levels,established a research framework,developed a self-administered questionnaire on the status of public health management in public hospitals and a questionnaire on medical personnel’s perceptions of public health in hospitals,invited experts to validate the self-administered questionnaire,A convenience sampling method was used to survey public health-related management departments and in-hospital medical staff in 55 public hospitals in Anhui Province from May to July 2022.The data were statistically analyzed using SPSS 26.0,and the main statistical analysis methods included descriptive analysis,t-test,chi-square test,one-way ANOVA,and multiple linear regression model.Results(1)The current situation of public health work in the sample hospitals:(1)Departmental settings: Only one tertiary hospital in the sample had a separate "public health department",while the public health management responsibilities of other hospitals were scattered in departments such as hospital infection office,medical department,preventive health department,etc.There was no independent public health department to coordinate the management of public health affairs in the whole hospital.(2)Funding sources: The main source of funding for public health services in the sample hospitals was mainly income from medical services(43.8%),and there was no statistically significant difference between the funding sources of public health services in the second and third level hospitals(P>0.05).(3)Service provision: The sample hospitals provided comprehensive public health services,among which the management of infectious disease diagnosis and treatment was the best implementation of public health services in each hospital,reaching 100%;however,the development of chronic disease and mental health services,which are generally more important at present,was not satisfactory.(4)Performance assessment: 58.18% of the public hospitals in the sample have included public health services in their internal performance assessment,but some hospitals still lack a complete public health performance assessment mechanism.(5)Information construction:Only the state-mandated information system for reporting infectious diseases has achieved full coverage in the sample hospitals,while 69.09% of the total number of hospitals have implemented the interface between the electronic health records of residents and primary medical service institutions,and only 45.45% of the total number of hospitals have an information system for monitoring and reporting of severe mental disorders.(2)Medical staff’s knowledge of hospital public health:(1)The support rate of the surveyed medical staff for hospital public health work reached 99.26%.(2)The overall level of medical staff’s understanding of hospital public health services was good,and the top three scores of public health services were health promotion and health education(4.19±0.765),infectious disease diagnosis and treatment and information reporting(4.17±0.770),and health emergency plans and response measures(4.15±0.790).((3)76.20% of the medical staff surveyed had participated in public health-related training;participation in training mainly consisted of infectious disease symptom monitoring and reporting(59.91%),public health safety training such as hospital infection(58.03%);medical staff wanted to further strengthen public health knowledge(92.03%),management and social medicine knowledge(73.97%),and professional clinical medicine knowledge(70.81%),etc.The top three factors selected by medical staff as constraints to the development of public health services in public hospitals were: a high clinical workload constraining the development of some services(57.21%),lack of professional public health staff(51.70%),and insufficient financial compensation for public health services in hospitals(45.84%).(5)Factors such as medical staff having participated in public health-related training,being concerned about public health,understanding policies related to public health development,and having a public health assessment mechanism in their hospitals significantly influenced the level of medical staff’s perception of public health in hospitals(p<0.05).Conclusions and recommendations(1)This study used a self-administered questionnaire to investigate the current situation of public health management in 55 second-and third-level public hospitals in Anhui Province,focusing on departmental settings,organization and management,service provision,performance assessment,and information construction,etc.The study found that: public health work in public hospitals in Anhui Province is still at the exploration stage,and there are still shortcomings to be improved and perfected,i.e.,the responsibilities of public health management departments in the sample hospitals are scattered,the shortcomings of public health services need to be made up,there is a lack of a perfect public health performance incentive mechanism,and there are weaknesses in public health information construction in hospitals.(2)A survey of medical staff found that: the medical staff of the sample hospitals had a medium to high level of awareness of public health services,and the services with good awareness were health promotion and health education,diagnosis and treatment of infectious diseases and information reporting,and health emergency planning and response measures,while the awareness of other services needed to be improved;the participation of medical staff in public health training was generally good,but 23.21% of medical staff had not participated in relevant training,and the training content was relatively homogeneous.However,23.21% of medical staff have not participated in relevant training,and the training content is relatively single and fixed;possible factors influencing medical staff’s awareness of public health in hospitals are: participation in training,concern,understanding of policies related to public health development,and the existence of public health assessment mechanisms in their hospitals.(3)It is suggested that in the future,we should strengthen top-level design and clarify functional positioning;coordinate the construction of public health departments to enrich the public health management team;make up for the shortcomings of public health services and improve the level of public health services;improve the public health performance assessment mechanism and increase the motivation of medical staff;strengthen the construction of public health informatization and build a public health big data platform;strengthen public health training for medical staff and enhance their public health awareness.