ABSTRACT
Objective To assess the knowledge and attitude towards hierarchical medical system among patients in Beijing Xicheng district community health service centers.Methods A questionnaire survey was conducted between July and August 2016,among randomly-selected patients who were visiting community health service centers in Beijing Xicheng district.Results A total of 2 770 patients were investigated.The percentage of patients who knew the hierarchical medical system was 62.2％ (1 722/2 770).Logistic regression showed that the degree of knowledge was significantly correlated with the visit number in the recent year and the education levels of patients.The percentage of patients who had a positive attitude to the system was 89.5％ (2 478/2 770).The main reasons for negative attitude to the system were "worry about the delay of treatment","inconvenience" and "fewer drugs in community health service centers" and "weak capacity of community health service centers".Logistic regression showed that the education level was negatively correlated with the attitude.In the case of mild illness,2,485 (89.7％) participants would chose "community health service center or service station".Conclusions The knowledge of hierarchical medical system among patients in community health institutions are moderately high,while most of them have positive attitude towards the system.The service capacity of community health service institutions should be further improved,and publicity should be strengthened to improve the awareness of hierarchical medical system among community residents.
ABSTRACT
Objective To measure the gap of community health staffing and establish new norms for community health facilities by means of the WHO Workload indicator of staffing need (WISN) method,for reference of the government in evaluation and decision making of community health staffing. Methods With Xicheng District of Beijing as an example,we collected data on community health staffing and calculated the total demand,measuring the total demand and supply,and gap or surplus in the staffing.Results in 2013,the demand of community health staffing was about 1 7.18 million standard equivalents in Xicheng,while the supply was 10.5 12 million.The WISN ratio was 0.67 for community health supply and demand,in which the ratio of physicians was close to 1,while that of nurses and public health workers was far below 1.850 extra community health staff was needed to reach the total of 2 602 persons.Conclusion The demand and supply of community health service in Xicheng District was seriously unbalanced,a huge gap featuring overstaffing of nurses and inadequate public health workers.This results from the enhancement of primary public health services and rising utilization of community healthcare services in recent years,which deserves high attention from government of all levels,by increasing the staffing of community health staffing standards.