Survey Research on the Development of Urban Community Health Service Centers

Abstract

Background The urban community health service centers in China have developed for nearly 20 years, but there is a lack of systematic research on their development, progress made, and existing problems. Objective To propose suggestions for the high-quality development of urban community health services centers in China by analyzing their development situation. Methods In October 2022, 50 community health service centers were selected from 13 provinces in the eastern, central and western regions by convenience sampling method. A self-developed research questionnaire based on the key core indicators for the assessment of urban community health services centers included two parts of basic data and evaluation content. Basic data included jurisdictional area, number of employees, number of outpatient visits, etc; the evaluation content included 4 gradeⅠindicators (institutional configuration, service function, service mode, and service support), 13 GradeⅡindicators and 33 GradeⅢindicators. The data of year 2006 (or the first year of the hospital's establishment and data) and 2021 were compared, and the survey results were reported in through "sojump". Results (1) Basic data: the number of community health service centers established before 2006 were 24 (accounting for 48.00%), and 26 after 2006 (accounting for 52.00%) ; comparing the year of 2006 or the first year of establishment, and the year of 2021, the number of employees was 67.00 (40.00, 101.00) and 94.00 (62.00, 162.00) respectively; the number of outpatient visits was 39 324.00 (22 620.00, 118 384.00) and 106 259.00 (44 999.00, 225 851.00) respectively; the total score of the questionnaire was 36.50 (28.13, 46.00) and 69.00 (56.38, 76.00), respectively. (2) The median scores of Grade I indicators institutional configuration, service mode and service function in 2021 were all higher than those in 2006 or the first year of establishment. The relative scoring rate of Grade I indicators in 2021, institutional configuration was 77.27% (25.50/33.00), service mode was 61.84% (23.50/38.00), service function was 76.92% (10.00/13.00), service support was 47.37% (9.00/19.00). The median score of structure area in the institutional configuration indicators was 0; among the service function indicators, the relative scoring rate of the diagnosis and treatment of common and chronic diseases in the community, and the inpatient service content were all 100.00%; the relative scoring rate of inpatient bed utilization rate was 25.00% (1.00/4.00). (3) Score of GradeⅡ、Ⅲ evaluation indicators of service function, service mode, and service support: The median score of public health items in service function increased from 2.00 points in 2006 or the first year of establishment to 9.50 points in 2021. The differences were statistically significant (P<0.05) in different years, with a relative scoring rate of 59.38% (9.50/16.00) in 2021; the relative scoring rate of resource integration in service mode was 100.00% in 2021. Among the service support indicators, the median scoring of general practitioners, public health practitioners and scientific research tasks all were 0; there was statistically significant difference (P<0.05) in the distribution of scores of general practitioners and scientific research tasks in different years. Conclusion The sustainable development of urban community health service centers is reflected in the gradual improvement of the relative scoring rate of institutional configuration, service function, service mode and service support. But the area of structure, inpatient service capacity and personnel ratio are seriously insufficient and the growth is very slow, which has become a constraint on the development of community health service centers.

Keywords

• primary health institutions|resource allocation|community health centers|community health services|high-quality|questionnaires