ABSTRACT
The control handles( including financing, provider payment, organization, regulation and behavior) proposed by World Bank in health policy research as the basic framework,and the nature and positioning of family doctors′ contract-based service as the precondition, we recommended the system framework of such a mechanism, comprising one contract, three regulations, five control handles and seven supporting policies. Such a framework can serve as the cornerstone for family doctors′ contract-based service experiment in Zhejiang province for the sake of hierarchical medical system.
ABSTRACT
Objective To examine the occupational stability,training needs and capacity building requirements of the general practitioners purposely trained to work in rural communities,for improvement of policies regarding their training and issues related. Methods There counties were selected by stratified random sampling, where general practitioners graduated from such training completed an anonymous questionnaire. Focus group interviews were made to officials of the local Health and Family Planning Commission,those of primary healthcare institutions,and general practitioners themselves. Results The of the 190 valid questionnaires recovered, male accounted for 34. 2% and female 65. 8%. These general practitioners were mostly satisfied with their working environment, social status, work stress and job achievement,yet with lower satisfaction with their salary and availability of medical devices. Consideration of resignation was reported by only 5. 3% of them,with more males than females. As high as 63. 2% of them prefer to work in hospitals of county level. 91. 1% of them held it as necessary to participate in standard resident training,and 98. 4% held it as necessary to have on-job training. 94. 7% of them have participated in further education to gain a bachelor degree in medicine. Conclusions These doctors were found with high stability to work in rural communities and low turnover intention. Further studies are required to encourage these general practitioners to serve rural communities in a long term, and to improve the standard resident training mechanism,and their career development.
ABSTRACT
Objective To explore the economic performance after the performance‐based reform at primary medical institutions in Zhejiang Province and put forward measures for improving primary medical services .Methods Questionnaire investigation was conducted among 84 primary medical institutions with staff over 20 .The financial statements of these institutions during 2009‐2014 were collected and studied as well .Results The average outpatients and emergency patients in 2014 increased 113.3% than that in 2009 .The total usage times of laboratory tests and other auxiliary examinations also increased(55.7% and 103.1% ,respectively ) ,yet with a decrease of inpatients.Moreover ,the proportion of income from traditional Chinese medicine (TCM )in gross income increased from 9.39% in 2009 to 17.14% in 2014 .The cost‐profit ratio of TCM drugs at half of such institutions exceeded 120% . Conclusions The performance‐based reform has motivated medical staffs of primary medical institutions and effectively vitalized such institutions.Rules and regulations of these institutions require further improvement .
ABSTRACT
10.3969/j.issn.2095-4344.2013.23.005
ABSTRACT
Objective To explore the functional orientation of township hospitals in developed areas to achieve goals of the ongoing health reform.Methods Two rounds of Delphi consultation was made among 18 experts from around the country to learn the degree of importance of every function.Results The experts' average seniority of service in their fields was 23.28±10.41 years.The positivity coefficients of the two-round consultation were 100％.Kendall' S coefficients of the two-round consultation were 0.226 and 0.265 (p＜0.01).These data are of statistical importance,suggesting consensus among these experts and the consultation meeting the needs of forecast.In these consultation,seven class-1 functions and and 27 class-2 functions were determined.Medical services and public health services account for similar proportion of work of township hospitals.Conclusion The functional orientation was feasible and forward looking,for reference of township hospitals in developed areas.