Study On Operation Situation And Countermeasure Of Village Clinic Under Health Services Integration Management In Xinjiang

Objective:To know the basic construction, current service ability, and villagers’ utilityof village clinic under health services integration management in Xinjiang, find theproblem and defect, propose improving method and measure, look for and formulatethought in line with national policy to adapt to basic village situation in Xinjiang andpromote the development and service ability of village clinic in Xinjiang.Method:Qualitative and quantitative methods are used to investigate54village clinics,73healthservices staffs in counties and villages,93rural doctors, and270residents in Moyu,Qinghe, and Hami of Xinjiang and evaluate302prescriptions in2weeks of2011selectedfrom village clinics. Result:(1) Situation of54village clinics: house: qualified rate ofarea is61.1%, rate of4-room separation is66.7%; drug: average59types, at most218types; armamentarium: distribution rate is61.9%. Distribution rate of diagnosis bed,stethoscope, sphygmomanometer, and thermometer is at most90%; village doctor team:11.3%of medical practitioners (assistants);39.8%of doctors major in clinical care;medical services: the top5diseases are hypertension, diabetes mellitus, upper respiratoryinfection, coronary heart disease, and digestive system disease; the top5drugs areamoxicillin, captopril, Ganmao Qingre Granules, Metformin Hydrochloride Tablets, andCephalexin.(2) Villagers’ utility of village clinics:65.3%of villagers see a doctor once ortwice in recent2weeks.34.8%of villagers regard the village clinics as the first choice.They do not choose village clinics for the medical technology level is low. They proposemost suggestions on medical instruments of village clinics.(3) Interview data: Moyu:“10-Uniform” requirements are proposed to complete standardized village clinicconstruction in2014; Qinghe:“5-Uniform” implementation plan is proposed to issuefavorable policy and financial management; Hami:“7-Uniform” rural health services integration management is implemented comprehensively, so Hami is the area with bestimplementation degree.(4) Pareto diagram analysis: main factors influencing thedevelopment of village clinics are fund investment, drug reimbursement types, and villagedoctor structure. Conclusion: Change the concept, control the blind expansion of countyhospitals; accelerate the standardized construction of village clinics based on the villages;make clear the positioning of village doctors, enhance the team construction, and cultivatethe successive talents; construct feasible long-term system for further education andtraining; village merger may be carried out soon; develop national medicine and formulatebasic drug system based on requirements of village doctors; implement the subsidy tovillage doctors by various channels and promote their treatment.