Service functions of private community health stations in China: A comparison analysis with government-sponsored community health stations

Abstract

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Keywords

private community health stations / government-sponsored community health stations / services functions

References

[1] YouC., YaoL., ScarfC.. External environments facing community health services facilities that belong to state-owned enterprises or public services units in China. Qual Health Res, 2008, 18: 821-829

[2] YipW., HsiaoW.C.. The Chinese health system at a crossroads. Health Affairs, 2008, 27(2): 460-468

[3] YipW., MahalA.. The health care systems of China and India: Performance and future challenges. Health Affairs, 2008, 27(4): 921-932

[4] HillierS., ShenJ.. Health care systems in transition: People’s Republic of China part I: An overview of China’s health care system. J Public Health Med, 1996, 18(3): 258-265

[5] LiuY.. China’s public health-care system: facing the challenges. Bull World Health Org, 2004, 82(7): 532-538

[6] WanF., ZhangL.. Discussion on the development of community health services. Hosp Adimin J Chin PLA, 2005, 12(4): 338-339

[7] YangJ., GuoA., WangY., et al.. Human resource staffing and service functions of community health services organizations in China. Ann Fam Med, 2008, 6: 421-427

[8] DibH., PingS., ZhuM., et al.. Evaluating community health centers in the City of Dalian, China. Health & Place, 2010, 16: 477-488

[9] PR China State Council. Decision of the Central Committee of the Communist Party of China and the State Council concerning health reform and development. Documents issued by State Council. 1997. Available at: http://www.jdzx.net.cn/article/402881e4094442080109473d4662001f%5C2009%5C3%5C402881e409444 208 0109487e45b1002a.html. Accessed January 15, 1997.

[10] PR China State Council. Suggestions on the development of urban community health services. Documents issued by State Council. 2006. Available at: http://www.gov.cn/zwgk/2006 -02/23/content 208882.htm. Accessed February 21, 2006.

[11] PR China State Council. Suggestions on the basic standard of urban community health centers and stations. Documents issued by Ministry of Health and State Administration of traditional Chinese medicine. 2006. Available at: http://www.moh.gov.cn/publicfiles/business/htmlfiles/zwgkzt/pfybj/200804/18170.htm. Accessed June 30, 2006

[12] WanF., LuZ., ZhangJ.. Comparison of family clinic community health service model with state-owned community health service model. J Huazhong Univ Sci Technol, 2002, 22(4): 381-383

[13] PR China Ministry of Finance, Ministry of Health, National Development and Reform Commission. Subsidy suggestions on urban community health services. Documents issued by PR China State Council. 2006. Available at: http://www.gov.cn/zwgk/2006-08/10/content 359226.htm. Accessed July 13, 2006

[14] 11 ministries of PR China. Suggestions on the development of urban community health services. Documents issued by 11 ministries. 2002. Available at: http://zqs.mca.gov.cn/article/sqjs/zcwj/200711/20071100002865.shtml. Accessed August 20, 2002

[15] PR China State Council. Suggestions on reform of the pharmaceutical and health care system. Documents issued by PR China State Council. 2009. Available at: http://www.gov.cn/jrzg/2009-04/06/content_1278721.htm. Accessed April 6, 2009

[16] ChiY., YaoL., ZhangL.. Advantages and challenges of private community health services. Chin Health Econ (Chinese), 2007, 26(12): 10-12

[17] YaoL., ZhangL., LiJ., et al.. Analysis of outpatients in private community health system. Chin Health Econ (Chinese), 2008, 27(5): 60-62

[18] RobertL., PhilipA.. Pursuing community-oriented primary care in a Russian closed nuclear city: The Sarov-Los Alamos community health partnership. Am J Public Health, 2002, 92(11): 1740-1742

[19] NadjaG., SimonL., VirginiaB.. The emergence of community health worker programmes in the late apartheid era in South Africa: An historical analysis. Soc Sci Med, 2010, 71: 1110-1118

[20] AmitaG., SuvarnaS., AjayG., et al.. Stigmatizing attitudes and low levels of knowledge but high willingness to participate in HIV management: A community-based survey of pharmacies in Pune, India. BMC Public Health, 2010, 10: 517

[21] MillerR.H., WestC.E.. The value of electronic health records in community health centers: policy implications. Health Affairs, 2007, 26(1): 206-214

[22] CashmanS.B., SavageauJ.A., LemayC.A., et al.. Patient health status and appointment keeping in an urban community health center. J Health Care Poor Underserved, 2004, 15(3): 474-488

[23] XuJ., WuN., JinS., et al.. Analysis of inpatient bed allocation equity and utilization in the city community health service center of China. J Huazhong Univ Sci Technolog Med Sci, 2010, 30(2): 141-144

[24] RustG., BaltrusP., YeJ.L., et al.. Presence of a community health center and uninsured emergency department visit rates in rural counties. J Rural Health, 2009, 25(1): 8-16

[25] MillerE., DeckerM.R., SilvermanJ.G., et al.. Migration, sexual exploitation, and women’s health: a case report from a community health center. Violence Against Women, 2007, 13(5): 486-497

[26] PrislinM.D., MorohashiD., DinhT., et al.. The community health center and family practice residency training. Fam Med, 1996, 28(9): 624-628

[27] XuJ., WangW., LiY., et al.. Analysis of factors influencing the outpatient workload at Chinese health centers. BMC Health Serv Res, 2010, 10: 151

[28] RosenblattR.A., AndrillaC.H., CurtinT., et al.. Shortages of medical personnel at community health centers: implications for planned expansion. JAMA, 2006, 295(9): 1042-1049

[29] WilsonR., ShardaV.. History of community health center affiliations with the New England College of Optometry. Optometry, 2008, 79(10): 594-602

[30] WhelanC.. Primary care safety-net delivery sites in the United States: A comparison of community health centers, hospital outpatient departments, and physicians’ offices. JAMA, 2000, 284(16): 2077-2083

[31] ShieldsA.E., ShinP., LeuM.G., et al.. Adoption of health information technology In community health centers: Results of a national survey. Health Aff, 2007, 26(5): 1373-1383

[32] GusmanoM.K., FairbrotherG., ParkH.. Exploring the limits of the safety net: Community health centers and care for the uninsured. Health Aff, 2002, 21(6): 188-194

[33] LiuL.. The comparison analysis of different owners to develop community health services. Chin Health Econ (Chinese), 2003, 22(3): 7-8

[34] ZhuH., ZhangL., YaoL.. Analysis of politics and management system to private community health services. Chin Health Econ (Chinese), 2007, 26(11): 43-45