Enhanced Performance of Community Health Service Centers during Medical Reforms in Pudong New District of Shanghai, China: A Longitudinal Survey

Abstract

BackgroundThe performance of community health service centers (CHSCs) has not been well monitored and analysed since China’s latest community health reforms in 2009. The aim of the current investigation was to evaluate the performing trends of the CHSCs and to analyze the main factors that could affect the performance in Pudong new district of Shanghai, China.MethodsA regional performance assessment indicator system was applied to the evaluation of Pudong CHSCs’ performance from 2011 to 2013. All of the data were sorted out by a panel, and analyzed using descriptive statistics and a generalized estimating equation model.ResultsWe found that the overall performance increased annually, with a growing number of CHSCs achieving high scores. Significant differences were observed in institutional management, public health services, basic medical services and comprehensive satisfaction during the period of three years. However, we found no differences in the service scores of Chinese traditional medicine (CTM). The investigation also demonstrated that the key factors affecting performance were the location, information system level, family GP program and medical association program rather than the size of the center. However, the medical association participation appeared to have a significant negative effect on performance.ConclusionsIt can be concluded from the three-year investigation that the overall performance was improved, but that it could have been further enhanced, especially in institutional management and basic medical service; therefore, it is imperative that CHSCs undertake approaches such as optimizing the resource allocation and utilization, reinforcing the establishment of the information system level, extending the family GP program to more local communities, and promoting the medical association initiative.

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014

“…During the six-year study period, the survey results showed an increasing trend in satisfaction, regardless of whether they were urban or suburban community residents, but the overall satisfaction of urban residents was higher than that in the suburbs (P<0.001), whereas its average annual growth rate was lower than that in the suburbs. An increasing trend in overall resident satisfaction was predicted by 2018, in agreement with the conclusions of Sun Xiaoming[ 27 ]fromFudan University. The comprehensive satisfaction of the investigated community health centers was significantly different during the three years.…”

“…In addition, the average annual growth rate of the behavior correction rate and the control rate of hypertension and diabetes mellitus in urban areas were lower than those in the suburbs. Research by Sun Xiaoming [ 27 ]further suggested that almost all investigated communities have shown some improvement in performance over time, but we must recognize that health care reform in rural areas is a gradual process, and it takes time to exert a profound impact. Differences in the performance of the community health service centers can be attributed to social characteristics and the implementation of health care policies.…”

“…In the chapter evaluating the performance of the community health service center in Pudong New Area, Shanghai, Sun Xiaoming [ 27 ] at Fudan University highlighted that the overall performance of the investigated community health service centers increased annually over the past three years. Basic medical services, public health services and comprehensive satisfaction were significantly different.…”

Community health service center-based cardiac rehabilitation in patients with coronary heart disease: a prospective study

“…Therefore, since then, timely registration, efficient treatment and adequate follow up are considered as the routine work of CHSCs. Given the multiple advantages of primary care in the management of chronic diseases as indicated by previous studies [ 16 , 17 ], we conducted a CHSC-based CR program for CHD patients led by general practitioners and community nurses. Care delivery was through home visits on a personalized basis.…”

Iodine nutrition status and its association with microvascular complications in urban dwellers with type 2 diabetes

“…Huangpu district, located in downtown Shanghai, is the administrative, economic and cultural center of the metropolitan coastal city [12]. Pudong new district is the symbol of China's reform and opening-up [13]. We randomly selected half of patients with diabetes from the registration platform in each community healthcare center.…”