Evaluation The Effect Of Integrated Management Of Rural Health Service Pilot Counties In Xinjiang Minority Area

Objective:Through the investigation of Xinjiangminority area integrated management of rural health service Pilot County before and after analysis and evaluation, integrated management of rural health services, service ability changes of rural two health service institutions, to explore the pilot integrated management of rural health service in Xinjiangminority regions and existing problems, and put forward corresponding countermeasures and suggestions. Methods:(1) Qualitative research and quantitative research methods combining,46 key figures in pilot counties of in-depth interview, the basic situation of the pilot counties of the general description and analysis. (2) By using the method of horizontal comparison and longitudinal comparison combined, health service quantity, the pilot counties during 2010-2013 countryside two class health services personnel changes, the balance of payments change were analyzed. (3) The construction of patient within two weeks of health service use multiple regression model of number of residents and patients flow were analyzed by double difference method. (4) With rank sum test analysis of residents of rural two health service institutions satisfaction. Results:(1) The basic situation of the pilot counties:by the end of 2013, the population, the two pilot counties number of health institutions, health personnel, health room, and standardization of village health fees were increased in 2010. (2) The rural medical institutions service quantity:outpatient and emergency service quantity, patient services, health examination, the number of people in public health service, basic medical service quantity amount were increased in 2010, township and village and the implementation of integrated intervention increases more obvious. (3) Health personnel:the overall growth trend, the total number of township and village the implementation of integrated intervention to increase more, structure more reasonable. (4) Revenue and expenditure balance: a rising trend overall, the implementation of integrated intervention of township and village of drug income and expenditure reduced income, medical and public health expenditure increase. (5) The residents health service utilization: fold difference method shows the integration of rural health services to the residents visit number and treatment flow effect, the implementation of integrated intervention group residents within two weeks of outpatient number increase, the number of village clinics and township health hospital accounted for the ratio increased, in the county hospital the number of the proportion to reduce. (6) Resident satisfaction: rank sum test results show that the pilot county in 2013, the intervention group and the control group with difference on the satisfaction of rural two health institutions, the intervention group higher satisfaction. Conclusion: Since the implementation of the integrated management of rural health service pilot county rural two health institutions service conditions improved, the health team is constantly growing, public health service has been carried out smoothly, the implementation of the supervision and management of village health room, promote residents within two weeks of outpatient service utilization. But still facing health personnel shortage, low quality personnel, the problem of public health duty not clear etc... Recommendations from the attract and stabilize the grass-roots health team construction, stable and improve the quality of primary health personnel, strengthen the township health center of village health room management functions to solve.