| Object:Systematically evaluate the ability and the actuality of the community healthservice(CHS), Nanchang. Synthetic evaluate CHS development to find the mainproblems and challenges of the5districts in Nanchang. Pointed proposed to promotethe community health services of countermeasures, put forward the correspondingcountermeasures and suggestions, in order to promote the urban community healthservices balance development.Methods:By using the theory method, developed a questionnaire about the policyimplementation, organization construction, personnel team, service function andservice quality to investigate community health services,206CHS institutions werecensused the present situation investigation; Methods of survey service quality asprescription quality and customer reflection. Using stratified sampling extract20CHS institutions first and then mechanical sampling2000prescription from them. Byusing interception sampled503customers. All survey completed by training theinvestigators; The relative standard deviation, mean differences and standarddeviation of use, statistical description were used to statistical description. Finallychose the weighted RSR method evaluated the ability and the actuality of thecommunity health service(CHS) of Nanchang city.Result:At the end of2010, the survey of206CHS institutions, and2000prescriptions,503cases of person.1. Policy implementation of CHS agencies.CHS Performance salary system,National system for basic drugs, the state basic drugs zero error rate policy,organization into the basic medical insurance system, the implementation inproportion was18.45%,16.99%,16.99%,90.29%respectively, and per capita CHS special funds for was21.41yuan.2. CHS institutions construction. Nanchang2010CHS agencies construction, ofCHS center street coverage rate was97.9%, Equipment configuration ratio was78.30%, and building area is up to standard proportion was80.07%.3. Personnel team of CHS agencies. Nanchang2010Personnel team of CHSinstitutions, of health technicians, community nurses general practitioners, anaverage of1.29,0.520.26per thousand. By the end of2010, Nanchang received ofgeneral practitioners of standardized training "rules cultivates rate" for21.1%,. Thepassing rate of national general medical professional intermediate technicalqualification examination in Nanchang was16.67%,; Accept community nurse jobtraining post "rules cultivates rate" for36.47%.4,In the service function. CHS agencies outpatient and emergency number ofpeople were3,029,731times.Visit a patient at home, building domestic sickbed,turned on and turned down for an average of210,6,41,4people respectively.Health files file rate was82.46%, the standardization file rate was52.81%.Themanagement proportion of0-6years old children's health, holergasia,65years oldand above was55.4%,7.3%,82.7%respectively. High blood pressure managementproportion55.49%, standard management proportion57.95%, effective control ratesto69.7%. And which was51.56%,61.26%,68.26%respectively in the diabetesmanagement.5,In terms of quality of service.67.8%of the person that walk to thecommunity health services less than15minutes. The satisfaction rate of service asconvenient and wait time was higher, more than80%.Medical environment, serviceattitude, respect degree, explain exchange, privacy protection and think withoutexcessive medical the satisfaction were of all at about80%.The satisfaction ofservice price was the lowest for55.7%. The proportion of costomers of CHSawareness was for69.4%, utilization rate was50.9%. Community health serviceprescription costs an average was36.6yuan. Intravenous drip utilization rate of41.9%, hormones, antibiotics usage rate, the use of antibiotics usage and unitedabove was1.1%,55.2%and11.7%respectively. Institutions accounted for drug income proportion of46.67%.6.CHS development situation comparison.5districts of CHS were development,but in the specific indexes exist good and bad phenomenon. Weighted RSRsynthetical evaluation, the results showed that weighted rank and ratio of Wanli,Donghu, Qingshanhu, Qingyunpu, Xihu in order as0.5841,0.6000,0.6423,0.6821,0.7156.Points3classes sort found that the CHS of Xihu level for classy, and fourother jurisdictions level to medium.Conclusion:1.The policy implementation. Nanchang CHS policies were implemented, butdid not have a high level of coverage, nor carry out widely. The implement ofdifferent districts is different, but overall level were not high, of which CHSinstitutions into"the medical insurance" rates relatively better.The CHS institutionswhich held by social forces and government, should be guaranteed enjoy the fairnessof the policy. Should explore social forces "open the door to do" CHS institutionsperformance evaluation system and the measures for the implementation of themedicine, zero rate differential sales plan, etc. To strengthen the supervision of theorganization "the non-public owned", make corresponding management measures orsystem, to standardize the "the non-public owned" ingredients in the policyimplementation on possible irregularities.2.Organization construction. Nanchang CHS platform building more perfect, andappropriate compensation system and establish and perfect the house financingmechanism into the local economic and social development plans.3.General personnel team in CHS was shortage, general quality accomplishmentwas low. Should establish mechanism to adapt the population made up, such as talentreserve personnel system, the introduction of talent to build community with retained.Specific strengthen community medical staff position training, promote CHS teamgeneral literacy.4.Service function. Medical service "six of a function"were reflected, but payattention to treatment, contempt prevent phenomenon still exists, Should strengthenthe public health service, especially health managemen of women and children, chronic disease.5.Service quality. Nanchang community medical service to the service personconvenience and wait queue time satisfaction rate was higher, and on medicalenvironment, service attitude, respect degree, explain exchange, the satisfaction ofprivacy protection were fair, but the satisfaction of the service price was low, thecommunity public health service awareness and utilization rate was low. Prescriptionhormone and antibiotics utilization rate was on the high side. Should furtherdeepening "national base medicine sales" and "zero rate differential sales" policiesimplementation efforts. Should strengthen community public health servicepropaganda that community residents enjoy free government public health serviceequity. Improve the quality of prescription, and to reduce the dependence of theantibiotics and hormones excessive use of.6.CHS development situation comparison in urban areas. In the specific indexesexist good and bad phenomenon. Integrated rank from low to high was Wanli,Donghu, Qingshanhu, Qingyunpu, Xihu in order. To promote community healthservices nanchang city development, should strengthen the nanchang city CHSbetween the exchange and cooperation, learn from each other, complementarystrengths, and work together... |
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