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Research ArticleOriginal Research

Human Resource Staffing and Service Functions of Community Health Services Organizations in China

Jun Yang, Aimin Guo, Yadong Wang, Yali Zhao, Xinhua Yang, Hang Li, Roger Duckitt and Wannian Liang
The Annals of Family Medicine September 2008, 6 (5) 421-427; DOI: https://doi.org/10.1370/afm.888
Jun Yang
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Aimin Guo
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Yadong Wang
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Yali Zhao
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Xinhua Yang
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Hang Li
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Roger Duckitt
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Wannian Liang
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  • Figure 1.
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    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.

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    • View popup
    Table 1.

    Average Number of Different Staff Positions in CHS Organizations in 2003 in China

    CenterStation
    Staff PositionNo.%No.%
    CHS = community health services.
    Doctor24.036.83.542.7
    Nurse17.026.12.328.0
    Pharmacist5.88.90.89.8
    Laboratory assistant2.84.30.33.7
    Medical technician6.29.50.78.4
    Manager3.65.50.33.7
    Others5.88.90.33.7
    • View popup
    Table 2.

    Average Designation of Professional Titles in CHS Organizations in 2003 in China

    CenterStation
    Professional StatusNo. of Doctors%No. of Doctors%
    CHS = community health services.
    Senior-level title2.911.50.513.5
    Middle-level title9.437.11.540.5
    Junior-level title12.549.41.643.3
    No title0.52.00.12.7
    • View popup
    Table 3.

    Average Number of Doctors and Nurses and Their Medical Educational Background in CHS Organizations in China, 2003

    CenterStation
    Medical Educational BackgroundDoctor No. (%)Nurse No. (%)Doctor No. (%)Nurse No. (%)
    CHS = community health services.
    5–8-year post–high school training program6.0 (25.4)0.3 (1.8)0.7 (19.4)0.1 (4.0)
    3-year post–high school program9.2 (39.0)3.6 (21.2)1.6 (44.4)0.4 (16.0)
    4-year post–middle school program6.9 (29.2)11.1 (65.3)1.1 (30.6)1.7 (68.0)
    No medical educational background1.5 (6.4)2.0 (11.7)0.2 (5.6)0.3 (12.0)
    • View popup
    Table 4.

    Average Staff Training Expenditures per CHS Organization, 2000–2002 (USD:RMB = 1:7.7)

    CenterStation
    YearStaff 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).
    20001,3640.26650.30
    20011,7400.291040.34
    20022,1040.311560.37
    • View popup
    Table 5.

    Quantity of Some Services Provided by All CHS Organizations From 2000 to 2002 (in Thousands)

    Service200020012002
    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 services9,24711,09112,680
    Family (home) care bedsa6766.7128
    Home visits201229376
    Patient discharges from service6262.681
    • View popup
    Table 6.

    Hours of Service Availability in CHS Organizations in China

    Hours Open Each DayCenter No. (%)Station No. (%)
    CH=community health services.
    ≤823 (11.5)90 (17.8)
    9–1233 (16.6)206 (40.8)
    13–24143 (71.9)209 (41.4)
    • View popup
    Table 7.

    CHS Organizations Providing Different Public Health Services in China in 2003

    CentersStations
    Public Health ServiceNo.%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 care15377.322344.3
    Child care16281.823347.2
    Immunizations16180.924649.0
    Health recordsa17185.540078.7
    • View popup
    Table 8.

    Number of Noncommunicable Chronic Disease Management in CHS Organizations in China, 2000 to 2002

    200020012002
    Type of Chronic DiseaseCenterStationCenterStationCenterStation
    CHS = community health services.
    Hypertension81197112265159395
    Diabetes74189105255150388
    Stroke6916899218138329

Additional Files

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  • 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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The Annals of Family Medicine: 6 (5)
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Vol. 6, Issue 5
1 Sep 2008
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Human Resource Staffing and Service Functions of Community Health Services Organizations in China
Jun Yang, Aimin Guo, Yadong Wang, Yali Zhao, Xinhua Yang, Hang Li, Roger Duckitt, Wannian Liang
The Annals of Family Medicine Sep 2008, 6 (5) 421-427; DOI: 10.1370/afm.888

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Human Resource Staffing and Service Functions of Community Health Services Organizations in China
Jun Yang, Aimin Guo, Yadong Wang, Yali Zhao, Xinhua Yang, Hang Li, Roger Duckitt, Wannian Liang
The Annals of Family Medicine Sep 2008, 6 (5) 421-427; DOI: 10.1370/afm.888
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