Institution,Service And Public Satisfaction —Research Of Shanghai Community Health Service Policy Implementation

This paper studies Shanghai Community Health Service in the perspective of policy implementation from three aspects as institution, service and public satisfaction, and builds an analytical framework by the relations among the three factors. Pudong New Area is taken as a case to analyze the characteristics of institution and service system reconstruction in community health service process. Also, the survey data of 17 districts and counties in Shanghai about residents’satisfaction about community health service is taken to give empirical explanation. This paper argues that the process of policy implementation is institutional improvement and service system reconstruction process, the effect of policy implementation is affected or even determined by institutional excitation features and reconstruction efficiency features of service system.In the system analysis section, this paper takes Pudong New Area as an example, analyzes one of the key processes of policy implementation:institutional improvement and institutional designing process by three aspects:the family doctor system, health care system and the essential drug list system. In the research part of the service system, this paper takes Pudong New Area as an example,analyzes the other key processes of policy implementation:the service system reconstruction process from three aspects:the medical association, chronic disease management and pharmaceutical services. In the part of public satisfaction research, the paper describes Shanghai residents Satisfaction situation to explore the factors affecting satisfaction, the conclusion is that degree of public satisfaction is proportional to their awareness of community health services, and found the degree of awareness is the decisive factor of whether to sign the contract and whether to go to community health centers. Meanwhile, years of education, income, age will also have an impact on resident satisfaction and choice of contracting or treatment.Overall, the Shanghai community health services policy implementation effect comes from excitation of institution and efficiency of service system reconstruction.