2 [current situation of] Community medical service centers
7/11/2003 18:18
2.1 Framework
There are 2,422 medical facilities, including 435
hospitals and 229 sub-district centers (52.6%), in the 18 districts and 1 county
in Shanghai. Every sub-district has a basic medical institution (community
medical service center or village & township medical health center), with
18,100 beds (22.1%)in all. Sub-district facilities target the elderly most, with
1,360 beds (23.4%) designated for the Homes for the Elderly already.
All
residential block hospitals have been transformed into community medical service
centers, each serving an average population of 77,000, with minor regional
differences. These centers have set up 422 stations in the neighborhood
committees to serve a smaller population of 10,000 on average.
Village &
township health centers in the suburbs of Shanghai serve on average 43,000.
These centers have set up 2,218 stations in selected residential blocks, with
about one station for every 2,000 people.
Starting in 2003, Shanghai has
launched a three-year project to streamline these village stations so that
villagers can reach the nearest station within 15 minutes by foot.
By 2005,
all village & township health centers will have the same functions as the
community medical service centers.
Existing standards require that every
center will have a spacious hall for outpatient services with touch interfaces
for inquiries and electronic screens for direction. Also, they should be
equipped with lanes with handrails, aisles with gentle slopes for the disabled,
and toilets with sirens. There should be rehabilitation centers, health
education centers, information management centers, and outpatient centers for
health care consultation. There are also regulations for the size of the wards
and admitting rooms, and heating and cooling equipment.
2.2 Human
Resource
There are 24,000 employees, including a medical staff of 19,000,
at the community medical service centers and village & township health
centers. Among the 8,819 doctors, 57.6% have a background of junior college or
higher education and 13.9% above senior college, 80.0% are resident physicians
and 33.8% are physicians-in-charge. A team of 4,896 assistant doctors are
serving in local suburbs, with two in each sub-village health center.
The
local government is offering basic level education and training programs to
doctors and fixing job qualifications to transfer doctors with specialties into
general practitioners. The move is aimed at improving medical care and disease
prevention services in the basic medical centers.
Instituted by the local
health authorities and kept in line with the standard by the Ministry of Health
of China, the systemic program for general practitioners' training takes into
account the local situation.
It has a city-wide unified goal and a semester
agenda with contents to be covered in 600 school hours. It also designates
training sites, organizes stable teaching staff and sets evaluation
standards.
Currently more than 3,200 general practitioners have received
training, received certificates, and registered with the local health
bureau.
table1
Human Resources at the community medical
service center and village & township health center
number %in
hospital %in city
medical staff 19,154 80.4 (of all employed)
19.8
Including
doctors 8,819 46.0 (of medical staff) 27.2
nurses
4,819 25.2 (of medical staff) 13.8
table2
Educational
Background & Titles of the doctors at the community medical service center
and village & township health center
EB-Educational
Background
EB number (%) title number %
Post Graduate 14 0.2
Director/vice Director 456 5.1
Senior College 1,215 13.8 Physician-in-chief
2,533 28.7
Junior College 3,847 43.6 Resident Physician 4,065
46.1
Secondary Sch. 3,743 42.4 Assistants 1,765 20.0
3 Service
& Forms
The Sub-district (Village & township health centers) is
being transformed into community medical service centers, with focuses on goals
and attitudes. The centers are serving the patients in groups rather than as
individuals, actively rather than passively waiting. They are targeting more
elderly people, children, women and the handicapped (including migrants). They
are making full use of the community resources to satisfy patients' needs and
help foster good health. Community medical service centers have also set up
health archives for the residents, especially those above 60, who are under the
administration of the territory within the sub-district. Preventive group
activities targeting different ages, types and abilities, are providing the
residents aid and directions in health, rehabilitation, education, family
planning and sex.
Almost one-third of the cases of common, frequently caught
(occuring) diseases and chronic diseases are diagnosed at these city
centers.
table3
Community medical service centers and village
& township health centers
Projects Volume %in
city
Outpatient/Emergency Dept. 25.5971 million person-time 34.5
Inpatient Care 352,900 person-time 28.3
3.1 Main
Services
* Prevention & Health Care
Community prevention service
includes prevention against the acute diseases such as the acute infectious
disease, tuberculosis, vermin sis, venereal disease/AIDS, and chronic diseases
such as hypertension, coronary heart disease, cancer, psychopathy, diabetes,
dental and eye diseases.
It also plans immunization and manages school and
food hygiene,and environmental and vocational health protection.
Community
health care service includes:
--publicizing information for newly weds,
pregnant & laboring women, and genital hygiene,
--caring for the women,
especially those with chronic female sexual diseases, for the new-born,
kindergarten and pre-school children, and for the elderly whose personal records
show identified health
concerns.
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