Exploring China's Western and Central County Systems Performance Measured by Outcomes Framework Scores-A Cross-sectional Survey of Routine Healthcare Data

作     者：石军 张亮 刘岳 王江波 Chris Scarf 熊巨洋 

作者机构：School of Medicine and Health Management Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China Office of Academic Affairs Huazhong University of Science and Technology Wuhan 430074 China Center for Project Supervision and Management Ministry of Health Beijing 100009 China P.O. Box 636 Roseville NSW 2069 Australia 

出 版 物：《Journal of Huazhong University of Science and Technology(Medical Sciences)》 (华中科技大学学报（医学英德文版）)

年 卷 期：2011年第31卷第4期

页      面：419-425页

核心收录：

学科分类：0710[理学-生物学] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：China 2Office of Academic Affairs Tongji Medical Huazhong University of Science and Technology Ministry of Health of the People's Republic of China, MOH 

主　　题：county health systems performance outcome measurement 

摘      要：This study was designed to measure the performance of county health systems in central and western China utilizing routine healthcare data.Drawing on a literature review and expert consultation,the study established a theoretical framework and an indicator system for performance review.Questionnaires were designed and disseminated to collect empirical data on health system performance in four counties of two central and western provinces.Quantitative data were subjected to descriptive statistical analysis through SPSS12.0.Three dimensions were introduced in the performance review framework—health outcomes,financial risk protection and consumer and provider satisfaction.Health outcomes were assessed from four secondary indicators：infant mortality rate;maternal mortality rate;under-5 child mortality rate;and the incidence of Class A and Class B notifiable diseases.Financial risk was assessed using two secondary indicators：the proportion of the cost of inpatient care that was reimbursed under the New Cooperative Medical System（NCMS） insurance scheme,and the rate of NCMS funds utilization.The assessment of satisfaction was made using two secondary indicators：the overall satisfaction of local residents with healthcare services,and the satisfaction of health practitioners at the township and village level.The study indicated better health system performance in the two counties in Chongqing than those in Shanxi.It was concluded that outcome framework scores can fairly reveal performance differences among county health systems in central and western China,and can provide practical evidence for optimizing the operation and inputs of county health systems.Caution needs to be exercised in generalizing such performance outcomes as many factors such as spending and organization that contribute to county health system performance were not included in the study.