Research on the Equity and Optimal Allocation of Basic Medical Services in Guangzhou in the Context of COVID-19.

Optimizing the allocation of basic medical services and ensuring their equity are necessary to improve the ability to respond to public health emergencies and promote health equity in the context of COVID-19. This study aims to analyze the equity of Guangzhou's basic medical service and identify areas where health resources are relatively scarce. The spatial distribution and patterns of basic medical services were analyzed using kernel density analysis and standard deviation ellipse. The equity was analyzed using the Gini coefficient and Lorenz curve in terms of population and geographical area, respectively. Considering the medical demand and supply sides, the Gaussian two-step floating catchment area method was used to analyze the accessibility to different levels of medical institutions. The kernel density analysis and standard deviation ellipse showed that the spatial distribution of medical and health resources in Guangzhou is unevenly distributed, and high-level hospitals and medical resources are mainly concentrated in the centrum. From the perspective of population, Guangzhou's medical equity is generally reasonable. The accessibility of medical institutions differs with different levels, and the tertiary medical institutions have the best accessibility, while the unclassified, primary, and secondary medical institutions generally have lower accessibility. The accessibility of districts in Guangzhou varies greatly. Areas in the center are most accessible to basic medical services, while accessibility in outskirt areas has gradually decreased. Conclusion: The quantity of per capita medical and health resources in Guangzhou, as evidenced by basic medical services, is sufficient, but the spatial distribution is unequal. The developed city center enjoys more adequate healthcare resources than the distant suburbs. Primary healthcare should be built, especially in distant suburbs, to strengthen basic medical service equity in Guangzhou.

Current status of rural grassroots health service provision in Beijing suburb / 中华全科医师杂志

Objective To survey the current status of the rural primary medical service supply in Beijing suburb,and to discuss the relationship between policy environment and rural primary medical service.Methods A purposeful sampling method was adopted to select Beijing Huairou District as the study site.In July to August 2016 a questionnaire survey was conducted among 260 village doctors from 260 village clinics in 14 townships;21 village clinics were site visited;21 village leaders,21 village doctors,and 42 villagers were invited for in-depth interview.The impact of policy environment on the provision of =basic health service at the village level was analyzed.Results The facilities of the 260 village clinics basically met the needs,but the service quality was still insufficient.The basic situation of village clinics:174 villages (66.9％) were funded by the "1 486" project,164 (63.1％) village clinics were located in the center of the village.In 173 village clinics (66.5％) the legal representatives were village leaders,but 11 (52.4％) village officials thought that rural doctors should be the legal persons.The mean age of 260 village doctors were (62.7 ± 8.9) years.Among 260 village doctors,168 (64.6％) were working more than 40 years,149 (57.3％) had secondary medical education,72 (27.7％) had no medical professional qualification;247 (95％) held practice certificates of rural doctors and only 3 (1.2％) held medical license;244 (93.8％) village doctors took subsidy from the government.The continuing education was organized monthly by the township health centers.The source of training teachers was township health centers (247,95.0％).The teaching form was mainly audio-visual education (191,73.5％);the content was based on general medicine (245,94.2％).The top 5 basic medical service items provided by village clinics were the diagnosis and differential diagnosis of common diseases,family visits,measurement of blood pressure,respiratory and pulse rates,body weight,height and vision,and intramuscular injection.Most village doctors (199,76.5％) provided night-time medical service.For the medical care needs,22 (52.4％) villagers said they were basically satisfied.The most satisfying aspect was the service attitude,and the most unsatisfactory aspect was the equipment and facilities.The management function of village committee was mainly in personnel recruitment (231,89.5％),daily supervision (218,84.5％) and performance assessment (113,43.8％).The assessment of service quality was conducted by the township health service centers,particularly in public health service.Conclusions The current status of rural primary medical service still cannot fully meet the needs of rural residents.In order to upgrade the quality of rural primary medical service to meet the health needs of villagers,it is necessary to improve the internal policy environment,such as villager autonomy,socio-economic development and so on.

Re-discussion on basic medical services connotation in China / 中国卫生政策研究

The establishment of basic medical service system is the premise to realize that everyone will have access to basic healthcare rights. This study puts forward the basic medical services concept according to the evolution of basic medical services connotation and status quo of research at domestic and abroad. Based on the four basic characteristics’ “necessity, fairness, accessibility and efficiency”, the paper studies the connotation and governmen-tal responsibilities, and provides policy references for practical work in the future.

The screening strategy on basic medical services package of secondary hospitals in China / 中国卫生政策研究

Objectives:To formulate the specific basic medical services package that adapts to China’s health-care situations. Methods:With the optional items which are covered by medical insurance and the medical services price regulation in 2012 , the 2 phase and 5 steps experts consultation methods were applied according to the princi-ples of meeting characteristics and the floor level of basic medical services. Results:1343 items are included in the basic medical service package and finally 713 items in the supplementary package. Discussion and suggestion: The screening strategy combining medical insurance system ensures the chosen items’ economical efficiency. The basic medical service providers are not just restricted in primary medical institutions. The government responsibility should be highlighted and the basic medical insurance system should be developed to be the main financial subsidy re-sources.

A study on the classification method of basic medical services of 9 county hospitals in Wenzhou region / 中华医院管理杂志

Objective With the case of 9 county hospitals in Wenzhou region of Zhejiang Province,this paper made a research into the classification method of basic medical services,in order to round up basic medical services and make sure of basic medical needs of the people.Methods The methods of priority ranking,opinion focused and group-based evaluation were called into play to clarify the medical services of the hospitals,with an empirical research of the results of classification.Results The results indicated that among the 3847 medical services of Zhejiang Province,1325 were county hospital's basic medical services.Among them,201 or 95.78％,were used in high frequency,which rank as services deserving priority.Conclusion The study of the classification method of basic medical services could be used for clear division of the basic medical services in need of priority and attention.It provides the government with an optimal means to make better use of limited medical resources.