Study On The Framework Of The Tiers Of Rural Three-tier Health Care Network In China

Objective:This thesis researches the policy and the problem which happened during the process at the background of establishing the new country. It based on the research results from NSFC study of"the policy research for establishing a integrated rural area three-tier health care network"which is presided by professor Zhang, and analyzed the fitting framework in the tiers of health care network in rural area briefly after surveyed the factors and conditions of health care network in rural area of our country.Method:For achieving the research objective and insure the research quality, this research used the document study and normative analysis as the main methods. The methods include: (1) Document review and information analysis. To survey the factors and conditions of health care network in rural area of our country by collecting the domestic and foreign literature and relative research reports of the health service system in our country and foreign countries. (2) Normative analysis. To analyze the characteristic of service demand and the framework of health care network in different place by using the relative theory such as science policy, system theory, and management.Result:This research has got those results by relative actuality analysis and theory research: (1) There exist the disadvantage of the responsibility of the government, and imbalance development of the network in different place. As this reason, the interior of the health care service system become disorder and out-of-order development.(2) The amphibolous capability of the organization in three-tiers health care network makes the excursion of whole capability of the network system. The amphibolous responsibility and unconspicuous management exist in the network especially in township and country. As the hinge of health care network in rural area, township health center bared superfluous medical treatment; there has no specific definition of public health and primary medical treatment; the obsolete management system make the low quality of the health service, and it can't satisfy the demand of the inhabitant. The resource of the organization in village doesn't enough to satisfy the demand of the service that the health care capability has lost gradually. (3) The interior of the health care system are out of line, the function mechanism of the three-tier health care network isn't perfect, there has no guarantee for the function of the network. The hardware of the health care system can't match the service demand of the rural area, the software of this system isn't perfect at meanwhile, and those reasons above make the out of line between factors, and appear rupture between each tiers.Conclusion:When it can't get more improvement of the quality of each factors in the system, the improve of the capability of the system decided by its framework. The angle of view must be macroscopically, it must focus on improving the whole service system in rural area but not the organization in it. We must treat the primary health care and public health as the main target of the three-tiers network, and improve the relevant function of these relative organizations; the problem centralize at township and countryside, it suggest that to do a fitting conformity to these two tiers, and carrying out two kinds running mode under the same management system based on the development level in different areas, then to change the strategy of devotion from focusing on the county and township to focusing on the countryside, and realize the balanced development at last. To confirm the connection among different tiers, adjust measures to local conditions, implement fore and aft cooperation in the network, and carrying out the strategies of fitting running mechanism, supporting environment and fitting human resource.