Medical Service Capacity and Influencing Factors of Primary Health Care Institutions Under Medical Alliance

Abstract

Background The construction of medical alliance is important measure for deepening medical reform. It aims to move the focus and resource to primary health care institutions, and improve service capabilities. Studies have shown that the medical alliance can improve the service capabilities of primary health care institutions, but the exact reason for this is not clear. Objective To analysis the service capabilities of the of primary health care institutions, and explore the impact of service capabilities in the context of medical alliance. Methods In December 2019, we survey on staffing, outpatient and inpatient service and medical alliance construction of 381 primary health care institutions which participated in medical alliance in Chengdu by structured questionnaire. Local administrative departments of public health gave out and recovered questionnaire. With the number of staff, registered generals, beds, outpatient and emergency visits, admission, and the use rate of the beds as the indicator of the service capabilities, we used rank sum ratio to analyze the comprehensive medical service capabilities and divide them to 3 gear. Using orderly Logistic regression to explore the influencing factors of integrated medical services. Results The median number of staff in 381 primary health care institutions was 54 (48), registered generals was 4 (8), beds was 50 (50), outpatient and emergency visits was 49 460 (60 317), admission was 1 440 (2 071), the use rate of beds was 68.43% (45.18%). According to the rank and ratio, there were 61 (16.0%), 260 (68.3%), and 60 (15.7%) institutions with good, medium and poor comprehensive medical service ability, respectively. The analysis of orderly Logistic regression analysis showed that institutional building area, teaching rounds and remote film reading are the influencing factors of the comprehensive medical service capabilities of primary health care institutions (P<0.05) . Conclusion The medical service capacity of primary health care institutions in Chengdu, Sichuan Province are relatively good. Institutional building area, teaching rounds and remote film reading in the medical assistance method significantly affect the comprehensive medical service capabilities.

Keywords

• medical alliance|primary health care institutions|medical service capacity|root cause analysis|chengdu