Article Figures & Data
Figures
- Figure 1.
Sampling flow of community health services centers and stations in 2003 in China.
a Five cities specifically designated in the state plan (this city is similar in size to a provincial capital) include Xiamen, Ningbo, Qingdao, Shenzhen, and Dalian, which are controlled by provincial governments politically and managed by the central government economically.19
b Four municipalities (a municipality is roughly equivalent to a province) are directly under the jurisdiction of the central government, including Beijing, Shanghai, Tianjin, and Chongqing.
c Considering level of local economic as a stratification factor, 27 provinces were stratified into 7 strata. Every stratum includes 4 provinces with similar economic levels, except 3 provinces in the last stratum. Each province was selected from every stratum by simple random sampling.
d Seven capitals of selected provinces were selected in terms of economical and political characteristics.
Tables
- Table 1.
Average Number of Different Staff Positions in CHS Organizations in 2003 in China
Center Station Staff Position No. % No. % CHS = community health services. Doctor 24.0 36.8 3.5 42.7 Nurse 17.0 26.1 2.3 28.0 Pharmacist 5.8 8.9 0.8 9.8 Laboratory assistant 2.8 4.3 0.3 3.7 Medical technician 6.2 9.5 0.7 8.4 Manager 3.6 5.5 0.3 3.7 Others 5.8 8.9 0.3 3.7 Center Station Professional Status No. of Doctors % No. of Doctors % CHS = community health services. Senior-level title 2.9 11.5 0.5 13.5 Middle-level title 9.4 37.1 1.5 40.5 Junior-level title 12.5 49.4 1.6 43.3 No title 0.5 2.0 0.1 2.7 - Table 3.
Average Number of Doctors and Nurses and Their Medical Educational Background in CHS Organizations in China, 2003
Center Station Medical Educational Background Doctor No. (%) Nurse No. (%) Doctor No. (%) Nurse No. (%) CHS = community health services. 5–8-year post–high school training program 6.0 (25.4) 0.3 (1.8) 0.7 (19.4) 0.1 (4.0) 3-year post–high school program 9.2 (39.0) 3.6 (21.2) 1.6 (44.4) 0.4 (16.0) 4-year post–middle school program 6.9 (29.2) 11.1 (65.3) 1.1 (30.6) 1.7 (68.0) No medical educational background 1.5 (6.4) 2.0 (11.7) 0.2 (5.6) 0.3 (12.0) - Table 4.
Average Staff Training Expenditures per CHS Organization, 2000–2002 (USD:RMB = 1:7.7)
Center Station Year Staff Training Expense, $ Within Total Expenditure, % Staff Training Expense, $ Within Total Expenditure, % CHS = community health services. USD:RMB = US dollar:rénmínbì (The exchange rate of the US dollar against the Chinese currency, yuan). 2000 1,364 0.26 65 0.30 2001 1,740 0.29 104 0.34 2002 2,104 0.31 156 0.37 - Table 5.
Quantity of Some Services Provided by All CHS Organizations From 2000 to 2002 (in Thousands)
Service 2000 2001 2002 CHS=community health services. a Family (home) care beds are an in home service provided for patients with chronic diseases or terminal illness who cannot travel to a clinic for doctor visits. Outpatient services 9,247 11,091 12,680 Family (home) care bedsa 67 66.7 128 Home visits 201 229 376 Patient discharges from service 62 62.6 81 Hours Open Each Day Center No. (%) Station No. (%) CH=community health services. ≤8 23 (11.5) 90 (17.8) 9–12 33 (16.6) 206 (40.8) 13–24 143 (71.9) 209 (41.4) Centers Stations Public Health Service No. % No. % CHS=community health services. a The health record, a useful tool for CHS based on a problem-oriented medical record, is somewhat different from the traditional inpatient and outpatient record, which consists of a personal health record, a family health record, and a community health record. Maternal care 153 77.3 223 44.3 Child care 162 81.8 233 47.2 Immunizations 161 80.9 246 49.0 Health recordsa 171 85.5 400 78.7 - Table 8.
Number of Noncommunicable Chronic Disease Management in CHS Organizations in China, 2000 to 2002
2000 2001 2002 Type of Chronic Disease Center Station Center Station Center Station CHS = community health services. Hypertension 81 197 112 265 159 395 Diabetes 74 189 105 255 150 388 Stroke 69 168 99 218 138 329
The Article in Brief
Human Resource Staffing and Service Functions of Community Health Services Organizations in China
Jun Yang , and colleagues
Background The Chinese government is increasing its focus on providing community health services (CHS) to its population. This study reports on the development of staffing and service functions in the CHS organizations.
What This Study Found The delivery of basic clinical services and public health services is steadily increasing; however, more doctors and nurses are needed in CHS stations. Furthermore, 68% of doctors and 87% of nurses in CHS centers have low-level medical training, and 59% of CHS stations are open less than 12 hours per day. Health records are widely used, and both public health education and individual patient education have been widely adopted.
Implications
- Improvements are needed in training for doctors and nurses providing health services, including training in basic clinical services and management of noncommunicable chronic diseases.
- The authors call for increased governmental support for the development of CHS organizations.
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