Scientific concept of development of rural health research articles

							Scientific concept of development of rural health research article



 In recent years, the CPC Central Committee, under the loving care, national health services in
rural areas have made considerable progress, especially in health infrastructure are improved
remarkably. Take the county, the present, the county has 56 health units in full, the difference
between the preparation of a total of 975 (including 193 in full, the difference between the 782),
1007 health workers who have created 378 village health by. However, the requirements of
development, we believe that in the rural health system there are still some problems and
difficulties can not be ignored, to be further studied and solved.
 1, the current health system in the rural county Problems
 visit by a period of nearly a month, sit on, we think that the county's rural health development,
primarily in the following four problem:
 (1) years of accumulated institutional and structural problems have become increasingly
prominent, can not meet the requirements of developing rural health services. First, there is
institutional "Mishap." Countries have clear health benefits unit is of a certain nature of public
welfare institutions to require medical units to affordable, quality health care services do a good
job, and strive to meet the broad masses of the primary health services, government and relatively
inadequate level of financial assistance, can not solve the health care unit costs caused by losses.
At the same time, health units must follow the law of market economy running, its various
production elements are all determined by market price at any time and cost varies. Even if not for
profit, but it should also strive to ensure this, and this inevitably gives medical and health units
and the State "with certain welfare of the public welfare institutions," the qualitative contradiction.
Second, health resource allocation and structure is not reasonable. Relative surplus of urban health
resources, the county about 63% of health professionals, beds and medical equipment
concentrated in the towns, while nearly 60% of the urban health resources concentrated in the
county-level hospitals, urban and rural conditions and the ability of medical services is extremely
uneven. Third, the medical institutions operating mechanism and the lack of internal dynamism. A
small number of medical and health institutions to manage loose, service quality, technical level
and professional moral decline, medical error incidents have occurred, complaints from the masses.
Although since 2006, in township hospitals to implement the personnel system reform steadily, so
that has changed the face of township hospitals, the situation has improved, but the health centers
of economic and social "two benefit" is still unsatisfactory.
 (b) management system that is not impeded the development of rural health services. First, the
management system that is not rural hospitals, effective mechanism. The late eighties, the county
management of the county hospital's director of the county health bureau head over to the
township government, into the nineties then clear for the county, township and condominium. In
fact, both the township, or county condominium management, not management in place, nor to the
construction of township health centers and rural development to bring effective health promotion.
Second, law enforcement supervision system is not rural health and health-care market order is not
good enough. As law enforcement, lack of funding and personnel constraints and other objective
conditions, health oversight agencies over health supervision and law enforcement to focus on the
town, while the general supervision of the rural medical market looked very "weak." Meanwhile,
county health oversight agency for the county health administrative departments of subsidiaries, it
is difficult law enforcement in place, so that medical malpractice, medical malpractice occur and
affect the image of the medical profession, but also to the patient caused the two sides both
material and spiritual loss. According to preliminary statistics, from 2002 the new "medical
treatment regulations" were promulgated, the county there were 32 cases of medical disputes,
provide humanitarian compensation from the hospital up to 120 million.
  (c) small investment, low level of technology, medical and health institutions it hard to survive.
One small investment. Financial difficulties because the county since 2003, despite the financial
investment of health expenditure increased year by year, but with the health needs of the
construction and development there are still some gaps. Higher allocation for the completion of
reconstruction of dangerous tasks, in the absence of sufficient supporting investment, construction
had to borrow. The end of 2006, the county 25 township hospitals accrued liabilities totaling more
than 3.53 million yuan. Second, lack of equipment. 25 township hospitals throughout the county,
5.5 million or above is not a medical device. x-ray machine, ECG, semi-automatic biochemical
analyzer, gastric lavage machine, operating table for each of these commonly used devices for less
than 1 hospitals in Taiwan. Third, the less skilled. Total lack of health workers. County health
technicians per one thousand three people, including rural health technicians per thousand
population is only 1.6 people per thousand population of health workers were lower than the
provincial standard of 3.3 persons, can not meet people's health demand for services. Health
personnel is not quite rational. Such as the large rural hospitals due 17 employees, only one
intermediate grade doctors, mercury townships seven active employees is not one in the
intermediate grade. Health manpower shortage has restricted the county and stable development of
rural health services factors.
  (4) health care system is not perfect, and the gap between the needs of the people. First, the
measures are not adequate rural health services. Township prevention and care personnel Although
their pay is all entered the wage distribution centers, with basic protection, 但 operating funds
into the financial budget arrangements Mei You, Yi Xie Zhi Ze difficult to obtain insurance against
Qieshilvhang complete protection against inevitable Hui Ren Wu discount. Since 2006, the county
Health Organization to strengthen village-level building, built 145 village clinics, but this is a low
standard of construction, only minor injuries heal minor ailments, take some basic preventive
health care and public health services. Second, the basic medical needs of the farmers are not well
protected. Due to lack of equipment and technology is weak, there is still a small number of rural
medical institutions with a number of common diseases and multiple diseases are difficult to
timely diagnosis, and problems are more critically ill patients is difficult to timely diagnosis and
control. Once critically ill patients, the consequences are obvious.
  2, countermeasures and suggestions
  health system related to the vital interests of the masses in reform, development, and stability is a
huge project, it is very difficult, we must attach great importance to , seriously.
  (a) adhere to the scientific development concept to guide the rural health system reform. Rural
Health is an important part of the rural work, do a good job in the new period is to solve the rural
health work "three rural" issue, promoting the coordinated development of urban and rural areas,
economic and social development, maintain social stability and building a moderately prosperous
society in an important measure for improving the health of farmers, protection of rural productive
forces is of great significance. Party committees and governments at all levels should work in rural
health as the "Three Represents" and implementing the scientific concept of development of great
importance that the local economic and social development into the overall plan to build a
socialist harmonious society. Planning, finance, taxation, price, health, personnel, establishment,
propaganda and other departments to perform their duties seriously and actively participate in and
support the building of health services for rural health reform and development to create the
necessary conditions.

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  (b) adhere to the innovation management system to promote the development of rural health
services. First, we must strive to improve integration of resources. Do a good job of township
hospitals, township total education service centers and township prevention and the integration of
work, reproductive and maternal and child health services into areas of township hospitals,
township health centers bigger and stronger. According to county population, traffic and other
conditions, the county should set up medical units in seven counties as well as the rural Center
Hospital 5, 18 general township hospitals, anti-Preserving hospitals 2. Third, efforts to improve
institutions prepared to integrate. Planning departments to actively adapt to people's health needs
for health care, scientific and rational set organization with staffing. We recommend that the
preparation of health professionals in rural allocation, according to five health workers per
thousand standard configuration, the preparation of the full nature of the cause of the preparation.
The second is to focus on doing a good job functions of the integration. Mainly to strengthen the
functions of township hospitals center, clearly the main functions of the town center hospitals:
improve the internal management of hospital and constantly improve the level of medical
technology and services, is responsible for rural medical and health institutions within the area of
health technology guidance, good two-way switch consultation and so on. Township Health
Center is responsible for total integration of education services in rural and township prevention
and the implementation of "unity of administration, unified business management, unified
financial management." Responsible for the area of health and disease prevention, disease control,
maternal prenatal and postnatal care, infant and child health systems management, and education.
Meanwhile, the township hospitals of the area, village health organization and leadership,
personnel, business, medicine, finance to implement the "five unified" management and the
support of the government and relevant departments, the appropriate treatment to improve the
remuneration of village doctors.
  (c) adhere to the incentives to deepen the internal reform of rural health care institutions. First, a
good selection of Township Hospitals. Democratic recommendation can be taken, in accordance
with the open, equitable, competitive, merit, within the county health system, public hiring and
other means to produce. Really good style, understand technology, good management of the
selection to the township hospital president positions. Second, deepening the reform of personnel
system. Employers to break the old concept and system with full employment and the appointment.
Meanwhile, according to the number of personnel to determine the proportion of all categories of
personnel, the implementation of full competition for employment, truly utilized, can make the
best use. Third, improve the distribution system. To establish and perfect the mechanism of
competition and incentives, strict internal assessment system with distribution according to work
and by the combination of factors of production allocation, so that the level of sales and technical
staff, service attitude, the contribution of labor linked to mobilize the enthusiasm of workers.
President of the township hospitals, should be appropriate to improve treatment. The annual salary
system. Salary is not fixed, no ceiling, or floor. The accounting may be the hospitals per capita
income on revenue of 7% of salary.
  (4) insist on more money for rural health to a higher level. First, continue to increase health
investment. Effectively improve health budget, according to no less than the same period in fiscal
rate of increase in recurrent expenditure on health inputs. Second, the county finance the
government's rural health care institutions to set quotas and subsidies. Fixed subsidies include
immunization maternity and child care, infectious diseases and endemic diseases control, health
education and basic health services in poor areas. Subsidies will include infrastructure
construction, equipment purchase and Health President, anti-dried insurance professionals salaries
and social insurance pay part of the unit. Third, the rural non-profit medical institutions the
implementation of government guidance prices of medical services, for-profit health care
organization of medical price liberalization. On the non-profit medical institutions, disease control
and maternal and child health institutions such as income, exempt from local government funds,
their tax according to the Ministry of Finance, State Administration of Taxation of the relevant
provisions, state regulations prohibit the addition to the medical and health institutions in rural
areas levy any taxes.
  (5) adhere to the new rural cooperative medical care system, medical aid system and the rural
poor population subsistence allowances system for rural medical and health protection of health.
First, actively organize and guide farmers to establish co-ordination illness mainly new rural
cooperative medical care system, focusing on solving farmers suffering from infectious diseases,
endemic poverty caused by illness arising Poverty and problems. Second, poor families in rural
medical relief. Medicaid mainly poor farmers in rural five guarantees and families suffering from
serious illness in the form of relief when the medical costs for certain benefits, you can also
participate in local co-finance their health care. Medical aid funds through government investment
and the community donations raised through various channels. To establish an independent
medical aid fund, the implementation of individual application, the villagers Review Conference,
the Home department and approved by medical institutions to provide services to the management
system. Third, implementation of the Rural Poor personnel subsistence allowances. The
Government of the rural cooperative medical care and medical relief support, according to county
finance actual needs and financial circumstances, to arrange funding for medical help poor rural
families financial support to the implementation of cooperative medical care and assistance
according to the actual number of participants fixed subsidy.
  (6) adhere to enhance the talent development of the cause of building an innovative rural health
situation. Health administrative departments to develop training programs to effectively strengthen
the education-job training of health technicians, to improve the health workforce structure. 2015,
the county health agency medical personnel necessary to undergraduate classes as the main town
center hospitals for specialist students as the main body, the general township hospitals to
secondary or higher to all. County rural doctors practicing physician assistants must have higher
qualifications. Of the township hospitals after graduation working in the voluntary medical degree
or above of students who can not perform the trial period of wages, and pension insurance, basic
medical insurance, premiums paid Bufen, Lieru county financial budget, provide preferential
professional or technical positions. Continue to implement the urban medical personnel to rural
services, policy, restoration and promotion of the implementation of urban doctors attending
physician and the deputy chief physician before professional and technical positions to more than
one year rural health service system.
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