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...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 con-cerning 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 rec-ommendations 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.展开更多
Objective:To analyze the efficiency of community health service in urban and suburban areas of Shanghai.Methods:Fifty community health centers in Shanghai that registered to create“National Demonstration Community He...Objective:To analyze the efficiency of community health service in urban and suburban areas of Shanghai.Methods:Fifty community health centers in Shanghai that registered to create“National Demonstration Community Health Center”in 2013 were included in our study.The service efficiency was analyzed with the methods of econometrics based on Cobb-Douglas production function.Results:Two production functions were formulated for urban community health services and those in suburban areas;the equation for urban areas was:lnY=7.778+0.450lnL+0.350lnK+μ;and the equation for suburban areas was:lnY=6.329+0.728lnL+0.350lnK+μ.The results showed that among the inputs,labor had more effect on output than capital did.It also showed that marginal ben-efit of labor was different in urban and suburban areas.Urban community health centers were in the interval of decreasing returns to scale,while suburban community health centers were in the interval of constant returns to scale.Conclusion:Increasing human resource investment is a key factor for increasing community health service output.Due to the difference of scale merit between urban and rural areas,govern-ment or other policy makers should make the development policy for them accordingly.Those com-munity health centers in urban areas should pay more attention to the service efficiency and service innovation.展开更多
Objectives:From the view of everyday practices and the socio-technical coordination lens,this study aimed to analyz the gap between creators’intention and the users’implementation(mainly nursing staff and social wor...Objectives:From the view of everyday practices and the socio-technical coordination lens,this study aimed to analyz the gap between creators’intention and the users’implementation(mainly nursing staff and social workers)of an alert system in assisted living communities.Methods:Qualitative methods were employed by way of five user interviews and focus groups with six system developers.Modeling instruments were applied for data collection to analyze the different clinical workflows versus the expectations of the system development team.Results:Results indicate that the clinical workflow changed over time,which led to a mismatch of nurse care coordination,social practices,and technology use.The results show different mental models of the socio-technical practice.Applying the coordination theory,the following recommendations could be developed to overcome the mismatch.First,it is recommended that nursing staff set goals together.Second,a communication rhythmwith the nursing staff and developer teams should be established,with guided questions to facilitate the conversation,to shed light on the different workflows and the difference in social practices when using sensor technologies or alert systems.Third,a checklist for new employees should be created so they know how and on which devices to use the alert system.Fourth,the user experience with the alert system should be improved(e.g.,an improved user interface).Conclusions:This work indicates recommendations to close the mental model gap to overcome the mismatch between optimal use of the alert system and how the nursing staff is actually using it.展开更多
基金supported by agrant from"The National Urban Community Health Service System Building Project"of the Ministry of Health of China(No.)
文摘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 con-cerning 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 rec-ommendations 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.
文摘Objective:To analyze the efficiency of community health service in urban and suburban areas of Shanghai.Methods:Fifty community health centers in Shanghai that registered to create“National Demonstration Community Health Center”in 2013 were included in our study.The service efficiency was analyzed with the methods of econometrics based on Cobb-Douglas production function.Results:Two production functions were formulated for urban community health services and those in suburban areas;the equation for urban areas was:lnY=7.778+0.450lnL+0.350lnK+μ;and the equation for suburban areas was:lnY=6.329+0.728lnL+0.350lnK+μ.The results showed that among the inputs,labor had more effect on output than capital did.It also showed that marginal ben-efit of labor was different in urban and suburban areas.Urban community health centers were in the interval of decreasing returns to scale,while suburban community health centers were in the interval of constant returns to scale.Conclusion:Increasing human resource investment is a key factor for increasing community health service output.Due to the difference of scale merit between urban and rural areas,govern-ment or other policy makers should make the development policy for them accordingly.Those com-munity health centers in urban areas should pay more attention to the service efficiency and service innovation.
基金This work was supported by the National Library of Medicine grant #1R01LM01222.
文摘Objectives:From the view of everyday practices and the socio-technical coordination lens,this study aimed to analyz the gap between creators’intention and the users’implementation(mainly nursing staff and social workers)of an alert system in assisted living communities.Methods:Qualitative methods were employed by way of five user interviews and focus groups with six system developers.Modeling instruments were applied for data collection to analyze the different clinical workflows versus the expectations of the system development team.Results:Results indicate that the clinical workflow changed over time,which led to a mismatch of nurse care coordination,social practices,and technology use.The results show different mental models of the socio-technical practice.Applying the coordination theory,the following recommendations could be developed to overcome the mismatch.First,it is recommended that nursing staff set goals together.Second,a communication rhythmwith the nursing staff and developer teams should be established,with guided questions to facilitate the conversation,to shed light on the different workflows and the difference in social practices when using sensor technologies or alert systems.Third,a checklist for new employees should be created so they know how and on which devices to use the alert system.Fourth,the user experience with the alert system should be improved(e.g.,an improved user interface).Conclusions:This work indicates recommendations to close the mental model gap to overcome the mismatch between optimal use of the alert system and how the nursing staff is actually using it.
