Input-output efficiency analysis for children′s diagnosis and treatment service at 27 community health service centers in China / 中华医院管理杂志

Objective:To provide strategic suggestions for optimizing children′s diagnosis and treatment services in the communities, by means of analyzing the overall efficiency of children′s diagnosis and treatment services in the sample community health service centers, and learning the current input and output of children′s diagnosis and treatment resources.Methods:In April 2020, a total of 27 community health service centers in 14 cities were selected by random sampling. Data such as the number of medical visits by children aged 0 to 18 years and the area of pediatric diagnosis and treatment departments in the sample centers in 2019 were collected by self-filling questionnaires. Excel was used for data sorting. Data envelopment analysis(DEA) was used for data processing. The data processing tool was DEAP 2.1.Results:The average comprehensive efficiency, the average technical efficiency and the average scale efficiency of the 27 sample community health service centers were 0.445, 0.865 and 0.494 respectively. There were five DEA efficient centers, 4 DEA weak inefficiency centers and 18 inefficient centers. Six out of 18 DEA inefficient centers had redundant input of healthcare professionals capable pediatrics; 12 centers were short of children visits, and 15 were short of visits by children aged 0-6 years.The centers where DEA was inefficient were concentrated in the central region, the suburbs and " centers with independent pediatric clinics but without pediatric wards" .Conclusions:The comprehensive efficiency of children′s diagnosis and treatment services in the sample community health service centers is relatively low. Currently, the sample community health service centers are faced with such problems as small and insufficient input of children′s diagnosis and treatment resources in the community, unbalanced development of children′s diagnosis and treatment services in the region among others. It is suggested that on the basis of making full use of the existing resources to create the maximum output value, we should consider appropriately expanding the scale of resource input to improve the efficiency of children′s diagnosis and treatment services at the primary level and further give play to the value of the " gatekeepers" at the primary level in children′s diagnosis and treatment.

Measurement and analysis of community health staffing standards / 中华医院管理杂志

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.

Impact analysis on the health management programs among community-based 0-36-month-olds on their growth and development / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the impact of implementation on health management programs among the community-based 0-36-month-olds regarding their growth and development.</p><p><b>METHODS</b>18 Monitoring Bodies in 8 pilot areas were selected to enroll this study, using a multistage stratified cluster sampling method. All the children aged 0 to 36 months were followed, according to the health management specification, and their health archives were collected.</p><p><b>RESULTS</b>A total of 13 464 children were involved in the specified management program with a total of 59 648 person-time under follow-up, with 54.26% of them were boys. Results from the multi-layer linear model indicated that the average height of children in the specified management group was higher than that in the non-standardized management group. Children in the specification management group, their weight gain had also been more effectively controlled. At the same time, with the increasing number of follow-ups according to the specification, the prevalence rates of under weight, stunt, emaciation and overweight were all significantly decreased (P < 0.05).</p><p><b>CONCLUSION</b>The implementation of the community-based programs on 0-36-month-olds regarding their health management specification had improved children's growth and development.</p>

Analyses on the change of medical care and health services utilization of Yayuncun community residents in Beijing / 中华全科医师杂志

Objective To know the change of medical care and health services utilization of Yayuncun community residents in Beijing. Methods Using the prospective study, residents above 15 years old were selected to answer the Beijing Typical Community Resident Questionnaire designed by the local researchers. In 2004 and 2005, the baseline survey was carried. From 2006 to 2008, same questionnaire was used to follow-up survey, and 1412 residents were selected into the last study. Results The proportion of people who should see a doctor but not in past month were decreased, the differences among the three years were significant (P ＜ 0. 01 ); The top three reasons that who should see a doctor but not were the "medical care costs too high", "self- felt the sickness light", "self-treatment". The residents who went to the community health agencies increased from 2006 to 2008. The medical costs ( drugs, medical fees,inspection fees) decreased from 2006 to 2008, the differences were significant (P ＜0. 01 ) ;The satisfaction increased from 2006 to 2008, the differences were significant ( P ＜ 0. 01 ). Conclusion Under the comprehensive promotion of community health services in Beijing, the satisfaction and the utilization of medical care and health services were improved.