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Rural health policies are difficult to be implemented at the village level in China.From the perspective of health administrative departments and township health centers, this is due to the lack of the basic conditions of rural health policy and the basic ability of the rural health policy.But from the point of view of village doctors, this is because of the lack of personnel, funding and other embarrassing situations, especially due to crisis and risks are taken to the village clinics and village doctors by the township health centers.In fact, the main reason why the health policy is difficult to land at the village level is that the relationship between the township health centers and village clinics have not been rationalized, as can be specifically seen in weak position of village clinics compared with township health centers.The key to rationalize the relationship between the township health centers and village clinics is to strengthen the development capacity of village doctors, at the same time to get rid of the misunderstanding for village doctors in some of the thinking and policy and strengthen the accountability of primary authorities, and finally open up the relationship between the township health centers and village clinics.
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Objective:To analyze the status quo and problems of the health human resources of township health center.Methods:296 township health centers in 18 counties of 6 provinces were selected with typical sampling and workers in the centers as target population.Relative administrative officials and directors of township health centers were interviewed.Descriptive analysis and thematic analysis were conducted with quantitative data and qualitative da-ta.Results:The volume and distribution of human resources in township health centers are not balanced and the allo-cation standard of the middle area is low.The null establishment and the employees out of establishment coexist.The allocation of health human resources inside township health centers is not reasonable and the ratio of health profes-sionals is lower than national standard.The rate of senior professionals is low.That health workers are out of stock is a potential problem in some counties.Medical education is not matched with the demand of township health centers.The recruitment policy is inappropriate and the remuneration of health professionals is low.It is difficult for the worker in township health centers to get professional promotion.Recommendations:The structure of workers in township health centers and the recruitment policy should be adjusted.The path of professional promotion should be clear in order to ex-pand the space of career development of workers in township health centers.Improving the remuneration of workers in township health centers should be considered to increase the attractiveness of the post in township health centers.
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Objective To learn the status of health care personnel construction of primary health institutions in Jiangsu province. Methods In July 2015, cluster sampling method was adopted in which 14 areas from Jiangsu province were selected, then one or more township health centers from each area were selected , and a total of 23 hospitals were selected. Personal interview were applied to administrators, the medical staff and residents respectively. A self-made questionnaire was performed in medical personnel from different departments. The method of descriptive statistics was used to collect data of rural health care personnel in primary health institutions. Results A total of 521 questionnaires were collected. In the town hospitals, the average age of the health professional staff was 37 years old. 68.33% (356 people) of the staff had college diploma or technical secondary school diploma and 35.12%(183 people) of them had junior title. There were 10.94%(57 people) and 14.01%(73 people) of the staff had no title and no physician practice qualification respectively. Conclusion Grass-roots health personnel construction task is still formidable. Further efforts are needed to improve the educa-tional system of health talents. And the incentive mechanism should be improved to strengthen the at-traction and stability of grass-roots health personnel. Strengthening education and training for the exist-ing staff is also needed to intensify the ability to primary health care.
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Objective:To describe the current situation in the nursing practice and their turnover intention in township health centers, and to analyze the changing potential influence in the nursing practice scope and workloads on their intention to leave those health centers. Methods:By means of a questionnaire, we conducted a survey on 167 nurses and interviewed 44 of them, all from 45 township hospitals within three provinces in China. Results:Since the healthcare system reform, the nursing workload in the township health centers significantly increased. 62% of the re-spondents considered their workload as heavy. Typically, the nursing work accounted for about 60% and the public health service work accounted for only 21% of the working hours. About 30% of the respondents were intended to leave their current job. The participating public health service was associated with intention to leave the job after con-trolling the province, workload, marital status, formal position, educational level and length of nursing service (P<0. 05). Conclusions:Since the healthcare system reform, the nursing practice scope in township health centers has been expanded and the workload increased considerably. But so far, expanding the scope of the nursing work may have potentials in reducing the intention of nurses to leave their current positions.
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Objective:To analyze the job preference of doctors at township health center ( THC) and provide references for formulating effective policy. Methods:238 cases of doctors were sampled from Shandong, Anhui and Shaanxi provinces. Using a discrete choice experiment, we analyzed the data with a conditional logit model. Results:The most important job attribution was salary, followed by education for children, permanent post, work location, training opportunity, and years before promotion. The OR value of the monthly income of 8 000 yuan is 7. 0 compared to 2 000 yuan. Doctors will pay 3 857 yuan and 3 294 yuan respectively for better education for children and perma-nent posts. Monthly income increasing to 8 000 yuan will reduce the quitting rate from 35% to 8%, and providing better education for children and permanent posts will reduce 5%. The permanent posts at township health center and non-permanent posts in county hospital have the same appeal to the doctor. Conclusion:When choosing a job, doc-tors at THCs valued salary the most. Improving the education level for children can be beneficial for attracting and re-taining doctors at THCs. A permanent post is more attractive to doctors than non-permanent posts at THCs.
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Objective:To explore the productivity of township health services in Guangzhou. Methods:We use a nonparametric Malmquist index approach to analyze total factor productivity change in Guangzhou’s township health service. The panel data was collected between 2009 and 2013. Results: The average growth rate of Guangzhou’s township health service was 18 . 7% from 2009 to 2013 . This growth was mainly due to improved technical progress but not technical efficiency. Pure technical efficiency and scale efficiency have not developed simultaneously. Conclusion:The change in the total factor productivity was positively affected by technical progress, not by strategic management and business decisions inside township health centers.
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Objective: To describe the status of the basic public health service in township health centers, analyze the resource allocation which influences the supply of basic public health service. Methods: The data is based on monitoring project surveys collected by the health statistical information center, Spss13.0 and Excellare applied to make descriptive statistic analysis. Results:Overall, basic public health service has been carried out well in each area, but there are differences among the application rates of different basic public health service items; basic public health service can be effected by the level of basic public health input and the number of public health workers.
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Objective: According to ERG ( Existence Relatedness Growth) needs theory, analyze factors influencing the resignation probability in Township Health Centers (THC). Methods: Structural equation model was used based on ERG needs theory. The sample consists of 403 stuffs in the THC. Results: The result of model fitting goes well. The satisfaction levels of the needs to survive and the needs of relationship become the major influencing factors of resignation probability in the THC. Conclusion: To reduce the resignation probability in THC, it needs to guarantee their income and benefits, improve working condition and living convenience facilities.
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Objective To probe into the employment and turnover changes of health workers at township health centers,for analysis of the incentive preferences and methods characteristic of such people.Methods Questionnaire and interview investigations were made for 16 health centers to learn their personnel turnover from 2008 to 2010 in Junan county,Shandong province,and to learn their incentive preferences.Results Health workers of turnover tendency are mostly found among women,clinicians and nurses of college or above degree and those less than 39 years old.The top five incentive factors for such health workers are as follows:better working environment; better pay; better security for living; better hospital management; and better career development opportunities.Conclusion Township health centers should seize policy support of the health reform,by focusing on not only economic incentives such as the income and living conditions of health workers of turnover tendency,but also on non-economic factors such as career development opportunities.
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OBJECTIVE To survey the status quo of hospital infection management and countermeasures in township health center. METHODS To adopt a unified examination and assessment survey,the township hospital infection management,including organization,personnel training,monitoring,disinfection and isolation,occupational protection,sterile disposable medical supplies and medical waste management was investigated in 15 Lanxi Town ship Health Centers. RESULTS Only 2 centers had management organizations (13.33%),5 (33.33%) to participate in personnel/training,no one carry out the monitoring of hospital infection,with fuzzy concept about cleaning disinfection and sterilization and poor awareness of occupational protection. CONCLUSIONS Realizing a sound organization improving hospital infection management staff and intensive training,increaseing the investment and strengthening th supervision and inspection are in accordance with the law and guide management of patients in rural areas to be assured of a secure medical establishment.
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doctors from 72 township health centers in 3 counties of Jiangxi Province were given a written test in basic medical knowledge, clinical knowledge of prevention and healthcare and professional knowledge. The rate of excellence of the scores was 45.4% while the rate of failure was 16.9%. A comparative analysis is made of the differences in the scores of doctors of different sexes, ages, specialties, educational backgrounds, and professional titles. It is suggested that it is imperative to conduct training for all doctors so as to enhance the overall quality, to lay stress on the key points and focus on the tackling of the weak links, and to perfect the mechanism so as to promote the renewal of knowledge.
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Objective To evaluate the efficiency of the township health centers with the appropriate use of data envelope analysis (DEA) so as to provide methodological basis for such evaluation. Methods The composite indexes of the township health centers medical and preventive service output were designed by means of service equivalent and expert consultation and the township health centers relative efficiency scores were calculated by means of DEA. Results There were 9 units where DEA was effective, accounting for 5 4% of all the units, and the township health centers DEA scores took a downward turn year by year. Conclusion ① By developing the composite indexes of the township health centers service output, the present study has put more preventive and medical service output information in the DEA output index system. ② The overall efficiency of the township health centers is pretty low and is moreover taking a downward turn year by year.