Objective To provide references for the rational allocation of health personnel in rural hospitals through understanding the status of health human resources of rural hospitals in remote and poor areas of Sichuan Province. Methodes This study used cluster sampling method, combined with questionnaire survey and qualitative interviews. A total of 711 health workers of 29 rural hospitals in Pengzhou and Baoxing of Sichuan Province were interviewed. SPSS16.0 was used for descriptive analysis.Results The average age of rural hospitals health personnel in remote and poor areas of Sichuan Province was 30 years old. Post-secondary education accounted for 58.12%, and Bachelor degree or above accounted for 7.2%. The number of medium and senior professional titles account for 8.4 %. The ratio of doctors to nurses was 1:0.55. In the survey of health workers, those doctors with practice (assistant) license accounted for 38.5%, and those without any qualification occupied 27.1 %. Conclusions The professional titles of medical personnel of rural hospitals in remote and poor areas in Sichuan province are generally low. The distribution of professional categories is irrational. The staff in charge of prevention and care are inadequate. There exist a large number of unqualified medical workers. Therefore, the government should increase the investment in rural health and take measures to stabilize the team structure, introduce the talented, and strengthen the training for health personnel of rural hospitals to improve their overall quality.
目前,新型农村合作医疗正在我国300多个县(市)开展试点工作.然而,在农村总体经济实力不强又面临市场经济冲击的大形势下,建立新型农村合作医疗制度将是一项十分艰难、复杂的工程.本文讨论了新型农村合作医疗制度产生的历史背景及如何增强农民对新型农村合作医疗制度的信心问题.
The increasing need for healthcare services in rural areas cannot be satisfied because of the lack of healthcare professionals, and poor medical education and training. These result in the low competency of rural healthcare workers. Therefore, the medical education system needs to be reformed in order to improve healthcare human resources in rural areas.
Objective To investigate the basic condition and psychological health status of children in rural areas of Xibaipo town in Hebei province, learn the psychological problems of the leftover children and their influencing factors, and provide scientific basis for the school and family education for the leftover children. Methods A questionnaire survey was performed on 446 middle and primary school students in Xibaipo town, and the self-designed questionnaire was applied to collect the basic condition, family condition and psychological health status of the children. EpiData 3.0 and SPSS 17.0 were used to perform data entry and data analyses, respectively. Results The survey displayed that the leftover children accounted for 43.5% of the total number of students. The negative emotion of leftover children was significantly ber than that of non-leftover children (χ2=12.484, Plt;0.001), especially for children with both parents living far away. The main factors affecting children’s emotion were their academic performance and whether they were left behind by their parents. Conclusion The psychological health status of the leftover children is poorer than that of non-leftover children, especially for children with both parents working outside and mothers working outside. Being left over and the academic performance are the factors affecting children’s mental condition. More attention should be paid to the physical and mental development of leftover children and vigorous efforts should be exerted to formulate corresponding policies and take countermeasures so as to promote healthy growth of children.
Objective To systematically review and conclude the healthcare reform policy in rural China throughout the past 62 years. Methods This study was applied with PICOS structure to formulate research issues. National/ministry policies and documents on healthcare reform in rural China were systematically collected. The primary healthcare issues and healthcare reform measures carried out at each stage were studied, and, the criteria as population healthcare indicators, indicators for healthcare workforce and infrastructure in rural areas, healthcare expenditure indicators, and the results of national surveys for healthcare service were used to evaluate the reform performance achieved at each stage. Results A total 396 national policies on healthcare reform in rural China were included through comprehensive search. In accordance with the results of quantitative analysis on literatures, characteristics of economy system reform at each stage as well as actual advancement on healthcare reform, the reform courses of healthcare system in rural China in this study were divided into six periods as follows: national economy recovery and adjustment period, cultural revolution period, early stage of economy system transition, initial stage of healthcare reform, middle stage of healthcare reform, and implement stage for new rural cooperative medical system (NRCMS). The average policies of each period increased year by year, which generally showed as features as laying more emphasis on medical services than medicine, and thinking little of medical insurance. The population health indicators, sickbeds per thousand rural population and medical practitioners kept improving gradually. Yet the import of market mechanism and influence of international economy condition led to the decline in public welfare of healthcare system, increase of personal expenditure proportion among general healthcare cost, and duplicate content among some polices.Conclusion Commonwealth orientation is the fundamental principal to fulfill healthcare service system, thus performance on policies should be concluded in combination with the present national conditions, future requirements as well as evidence-based policy-making, and additionally, such performance should be improved during implementation.
ObjectivePublic health information collection is critical in improving the capacity of basic public health services. Our study took the "Wei Jian E Tong" APP as an example to evaluate the willingness and influencing factors of rural public health service personnel to continue using such APPs.MethodsWe applied exploratory sequential design in mixed-method research and chose Renshou county in Sichuan province as the representative region. Firstly, we used the personal in-depth interview to initially explore the status quo, applicability, continued willingness to use APP and other issues. Secondly, we used unified theory of acceptance and use of technology (UTAUT) and expectation confirmation theory (ECT) to construct a hypothetical model of influencing factors of user satisfaction. We then designed a structured questionnaire covering 7 measurement dimensions to survey all users of the APP at the survey site. Finally, we used structural equation model to verify the research hypothesis.ResultsA total of 21 individuals were interviewed in this survey, including leaders of township health centers, public health doctors, and rural doctors. Qualitative results showed the major defects were insufficient funds and policy support in the promotion and application, additionally lack of software functionalities and system incompatibility. A total of 593 valid questionnaires were collected from the quantitative survey on the satisfaction of township doctors and village doctors. Structural equation model results showed that seven direct hypotheses were established, of which compatibility had the largest effect value user satisfaction with a total effect value of 0.617, followed by facilitating condition (r=0.211), performance expectancy (r=0.137), effort expectancy (r=0.091) and social influence (r=0.068).ConclusionsTo promote the application of information collection apps in primary public health services and improve user satisfaction, the focus should be on solving software incompatibility and create interconnection among all levels of medical systems. At the same time, it is necessary to solve funding problems as a whole, optimize software functions, improve the performance evaluation system, and improve software training and promotion.
Objective Through investigating and analyzing the training status quo of rural doctors in Liangshan Yi Autonomous Prefecture of Sichuan province, to find out problems existing in the training. Methods In October 2010, the on-site questionnaires were distributed to 300 rural doctors from 13 counties who were studying at medical schools of Liangshan Prefecture. The data of their training status were recorded with Epidata 3.0 software and then analyzed with SPSS 16.0 software. Results Among the total 300 questionnaires distributed, 279 were valid with the response rate of 93%. The results showed that: rural doctors in Liangshan Prefecture were generally low in education background and short of knowledge and skills, and took over the burden of the training tuition; and the training content was not fully correlated with theirs actual demands. Conclusion This paper suggests, the in-service training should be conducted on the following bases: the actual situation of Liangshan Prefecture, the adequate consideration of characters of minority region, the improvement of training quality, and the formulation of supporting policies and implementing methods.
ObjectiveTo investigate the human resources of village doctors for integrated management among township hospitals and village clinics in Xinjing county of Chengdu in 2010, so as to provide the evidence for optimal allocation of human resources in village level. MethodsThe information of village doctors in 2010, such as age, gender, educational level, professional license and work experience, were collected and analyzed using Microsoft Excel 2003 and SPSS 13.0. Resultsa) In Xinjin county, 213 village doctors were managed by 11 township hospitals (TH) in 2010 with the average of 19 village doctors in each TH; b) only 3 out of 11 THs achieved the national requirement of at least one village doctor per 1 000 rural population; to a greater or lesser extent, the shortage of village doctors existed in the rest 8 THs; c) Among the village doctors, the male-to-female ratio was 2.2 (68.5% vs. 31.5%). The village doctors younger than 45 years, 45 to 59 years, or no less than 60 years accounted for 42.8%, 18.8%, 38.5%, respectively. Those who graduated from secondary schools or elementary schools accounted for 90% (52.6% and 38%, respectively). d) Only 94.8% had the village doctor license. Among the 213 village doctors, only 1.4% and 3.6% were registered doctors or assistant doctors respectively. Those who worked longer than 30 years, 20-29 years, 10 to 19 years, and 5 to 9 years accounted for 44.6%, 12.2%, 29.6% and 6.1%, respectively. ConclusionThe quantity and quality of the village doctors in Xinjin county were insufficient to meet the requirement with aging teams, low education levels, and lack of professional qualifications. Therefore, the related policies should be implemented to maintain the stability of the village doctor teams, to improve the qualification and quality of service, and to promote the sustainable development of primary healthcare services.
Objective To understand the demands on portable medicine kit of rural residents in well-off township hospitals, and to provide the basis for scientifically designing portable medicine kit for rural residents. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the demands on portable medicine kit for 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan province, respectively. Results The demand rate of 162 rural households on portable medicine kit was 75.3% (122/162). The main drugs that demanders expected in the portable medicine kit were cold medicine (86.1%), wound paste (82.0%), cooling oil (61.5%), essential balm (54.9%) and antihypertensive (34.4%); and the main medical devices that demanders expected were thermometer (82%), cotton swab (73%) and sphygmomanometer (32.8%). The sizes of portable medicine kit that demanders expected were 23.7±8.5 cm in length, 17.1±6.4 cm in width, and 14.1±6.5 cm in height. The main function characteristics of portable medicine kit that demanders expected were applicability (74.6%), safety (60.7%), light weight (68.0%), economics (60.7%), and waterproof (46.7%). A total of 72.1% of demanders expected the price of less than 15 yuan, and 91.8% expected kit made of hard materials as plastic as the first choice. Conclusion The demand rate of rural residents on portable medicine kit is higher in well-off township hospital. The design and production of portable medicine kit should fully meet the demands of rural residents. Only when sufficiant respect for the market demand is paid, can the promotion and application of portable kits will be ensured.
Objective The Chengdu initiative essential medicine policy is part of the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-rural Development. We aimed to investigate the current situation of medicine use in rural hospitals and community health service centers, so as to provide evidence for policy-makers to select essential medicines and facilitate rational use of medicines. Method We selected 7 township/community health institutions from which to collect medicine use information, including medicine category, number of medicine categories, cost and consumption. Descriptive analysis and the ABC classification method were applied for statistical analysis. Results The number of medicine categories used in the community health institutions was four times greater than that in the township health institutions. Traditional Chinese medicine preparations accounted for 40% of the total medicine cost. Polypharmacy, overuse of injections, and improper use of antibiotics were major manifestations of the irrational use of medicines. Conclusion The selection and use of essential medicines should be base on high quality evidence as well disease burden, the economic situation and specific demands in different areas. Drug and therapeutics committees should be set up to perform dynamic monitoring, education, evaluation and continual improvement of an essential medicines list.