Current Status Of Community Health Services In Shenzhen

ObjectiveThrough investigating the current status of community health services(CHS)system in Shenzhen and evaluating the effectiveness of CHS policies, the problemscould be found, which will be served as basis for establishing and improving the CHSsystem. In addition, it aims to make the development of CHS in Shenzhen morehealthy and continuous.MethodsInformation of CHS financial investment and policy making were gathered. Dataof CHS institutions’ financial status, personnel, equipment, health services providedand policy implementation were collected by general survey method. Using samplingsurvey to investigate CHS’s drugs using and price,961CHS utilizers wereinvestigated on service utilization and satisfaction by questionnaires. All collecteddata were analysed by discriptive statistics.ResultsIn2011, Shenzhen had8districts and10,467.4thousand residents. There were604CHS institutions. The annual health expenditure and the CHS special fundsreached6.76and0.75billion yuan respectively. The community public healthservices funds per capita reached42.5yuan.In2011, the first-treatment and two-way referral system had been implementedin the whole city. The city and all districts had draw up the community essential drugdirectory, implemented the pharmaceutical unified procurement and centralizeddistribution, launched the essential drugs zero-profit sale policy and the correspondingsubsidy policy.10national basic public health services, and performance appraisal program were carried out. Six districts facilitated CHS institution administrativecenters under health bureaus. Seven districts initiated the general practice registrationchange program. CHS institution’s revenue and expenditure two-line managementwere implemented in4districts.The mean fixed assets and bussiness housing area of the CHS institutions was2,687.5thousand yuan and534.95square meters.304CHS institutions hadTraditional Chinese Medicine consulting room and488had traditional chinesedrugstore. All the CHS institutions had equipped with ECG machine, B ultrasoundand blood glucose meter.572institutions had equipped with rehabilitation physicaltherapy equipments. There were43and355CHS institutions which had equippedwith biochemical analyzer and X-ray light machine. In2011, the total number of CHSinstitutions staff was7577, temporary staff accounted for56.68%. Among them,2431were registered general practitioners,432were Traditional Chinese Medicine doctors,370were public health doctors, and2881were nurses.In2011, the amount of the outpatient service provided by CHS institutionsreached32,303,400person-time, account for36.39%outpatient service of the city. Inaverage, a CHS institution treated285.52person-time outpatient referred from highermedical institutions；at the same time, referred857.22person-time outpatient to superhospitals. Health records coverage rate was90.98%among serving population and thestandardized record rate reached100%. In average, gross income was4,552.5thousand Yuan per CHS institution, business income accounted for60.05%.73.51%of business income was come from medical insurance. The income from drug saleaccounted for47.70%of the total income of outpatient services. The average totalexpenditure of CHS institution reached3,902.4thousand Yuan. There were238.63medications per100prescriptions; the average price of a prescription was48.13Yuan.The community public health service awareness rate was69.51%. The overallsatisfaction of CHS was76.99%.Conclusion and suggestionThe CHS system of Shenzhen had been strengthened. Investment in the CHSconstruction was large; Basic medical services provided by CHS institutions was enormous and public health services had been rising significantly; Two-way referralsystem run well; The basic drug policy was implemented by all CHS institutions, drugusing situation obviously improved. Despite all these achievements, there were alsosome problems, such as scarce personnel, Traditional Chinese Medicine system wasimperfect, low public health services awareness and utility degree, CHS satisfactionwas not high. We suggest that the government should make efforts to promote thestandardization of CHS institutions’ construction, pay more attention to theconstruction of service team, improve the service ability and level continuously, andlook to arise the CHS utilization and satisfaction degree.