Analysis of Development Status of Primary Medical and Health Institutions in Chongqing, China from 2015-2018

The important manifestation of social civilization proves to meet the demands of patients for medical treatment to the greatest extent through promoting grass-roots medical reform, improving construction of grass-roots medical and health institutions and improving their service capabilities. Chongqing, the youngest municipality in China, has a population of 34.04 million, is also a typical city with a prominent urban-rural dual structure. Construction and development of service system in primary-level medical and health institutions is of great significance for improving health of people in Chongqing. This essay uses observation variables such as “community health service center”, “township health institution” and “village clinic” as it’s basis and puts its research objects on Chongqing Statistical Yearbook 2015-2018, the latest data from the National Bureau of Statistics and from Chongqing Municipal Health Commission Statistics Bulletin 2015-2018. Through statistical methods, collected and sorted data are imported into EXCEL table, and corresponding database is established. While statistical indicators include composition ratio, utilization rate, average and etc. and a descriptive statistical analysis is performed. Research and study are given on changes of observation variables of primary medical institutions in Chongqing from 2015 to 2018. It is found that: the number of primary medical institutions showed a downward trend as a whole; the proportion of patients seeking medical treatment through primary diagnosis and treatment was still relatively high; composition of observation variable in township and village level is unreasonable; and slow growth happens in the number of township first-level medical and health institutions and the number of beds. In view of problems found in the research, the essay puts forward some solutions to improve construction of service system of primary health institutions in Chongqing, namely, to invest more in basic construction of primary medical and health institutions, to guide medical graduates to work in primary medical institutions and to increase training and guidance of primary medical technicians. In this way, we can better promote the development of primary-level medical and health institutions in Chongqing www.scholink.org/ojs/index.php/jar Journal of Asian Research Vol. 4, No. 4, 2020 2 Published by SCHOLINK INC. and provide citizens with more and better medical services.


Introduction
Grass-roots medical and health institutions, as the "gateway of medical institutions", are foundation of the entire medical system and play an important role in ensuring public health. The meaning of life varies from person to person and changes from time to time (Viktor, 2003, p. 110). With continuous deepening of China's medical reforms, the broad masses of people are attaching more and more importance to life and health and having further requirements for higher level and ability of medical services. For a long time, grassroots medical and health institutions have been in a weak link and developing very slowly in the entire medical system. With progress of society and improvement in degree of civilization and people's living standards, it is very important for primary-level medical and health institutions to develop their service capabilities and levels, so as to better meet people's needs for better health. Efforts should be made to improve the level of primary-level medical and health services in Chongqing, and to meet the requirements on capacity and level of primary-level medical and health services in Chongqing, China's youngest municipality with a population of 34.04 million.
The essay analyzes the current situation of primary medical and health institutions in Chongqing, finds out their existing problems, gives countermeasures to better improve the service system of primary medical and health institutions in Chongqing and to better service Chongqing citizens, especially grassroots people. Through this way can the close connection between people's health and happiness be enhanced (Liang, 2011, p. 177).

Research Objects
Research objects and main sources in this essay are Chongqing Statistical Yearbook (2015-2018), China Statistical Yearbook (2015-2018) and Chongqing Health and Family Planning Statistical Yearbook, and Main Statistics of Chongqing Health and Health. www.scholink.org/ojs/index.php/jar Journal of Asian Research Vol. 4, No. 4, 2020 3 Published by SCHOLINK INC.

Statistical Methods
Efforts are made to import the collected and sorted data into EXCEL table, to establish the corresponding database, to determine statistical indicators including composition ratio, utilization rate, average, etc., and to perform descriptive statistical analysis.

Number of Primary Medical Institutions
The

Beds in Grass-Roots Medical and Health Institutions
From the perspective of changes in the number of beds in primary medical and health institutions in Chongqing, the number of beds in community health service centers increased from 7900 in 2015 to 9400 in 2018, up 18.99% which shows the fastest growth among all grassroots medical and health institutions and exceeds the 15.25% increase in the total number of beds in primary-level medical and health institutions. However, the number of beds in primary medical and health institutions still shows less increase than that in the city, with latter being up 24.56% (from 176,700 to 221,100).

Human Resources in Primary Health Care Institutions
The key to enhance the capacity of primary medical services is talent (Lu et al., 2020, p. 27).

Medical Services in Primary Medical and Health Institutions
Primary medical care is the cornerstone of service effectiveness in the entire medical system (Zhao, 2020, p. 341

Conclusion and Suggestion
The following can be found through observing variables and changes in primary medical and health institutions in Chongqing, and comparing with the whole city: First of all, the overall number of primary-level medical and health institutions in Chongqing is declining. As the youngest municipality directly under the Central Government in China, Chongqing has long been plagued in its development due to its outstanding characteristics of dual urban-rural structure. With the central government's implementation of the Western Development and the direct administration of Chongqing, the city has achieved unprecedented development, its urban-rural dual structure has been eased to a certain extent. Increasing urbanization and rapid concentration of rural population in the city result in decreasing number of primary medical institutions year by year, especially at the township and village levels.
Secondly, the proportion of patients seeking medical treatment through primary care is still relatively high. Most patients, when having symptoms, go directly to rural primary medical institutions or community primary medical institutions. However, in view of current medical conditions in primary-level medical and health institutions, it is more difficult to accurately judge some more difficult diseases, leading to delaying timely treatment of patients. Third, composition of health service technicians at township and village levels is unreasonable. From current construction and development of grass root medical and health institutions across China, the state attaches great importance to developing grassroots medical and health institutions to ensure the health and safety of grass root people. Medical and health industry has the attribute of technology-intensive (Chen et al., 2020, p. 16), but it develops slowly due to constraints of geographical location, conditions and demographic changes at the grass root level, especially towns and villages. In particular, it is more difficult to build a team of professional health technicians. Many institutions are run by the government, which are badly restricted in various aspects and will exist for a long time, thus leading to a lack of inside vitality for reform. Meanwhile, with the spread of openness, more and more private medical institutions have appeared in towns. Although they still need to work in accordance with relevant national laws and regulations, they are relatively flexible with better incentive mechanisms and great motivation to become bigger and stronger. Therefore, both internal and external reasons make it difficult for large-scale government-run medical institutions to carry out large-scale expansion. While the number of beds cannot increase rapidly, or even may decrease with changes of population structure of the township.

Suggestion
First of all, to invest more in basic construction of primary-level medical and health institutions.
Construction of the community health service system has attracted the attention from the whole society (Li et al., 2013, pp. 9-12), especially construction of grass root medical infrastructure requires a large amount of government investment. Given that China attaches great importance to the construction of primary-level medical and health institutions, government should increase its investment in building primary-level medical institutions. Efforts should be made to promote infrastructure of grass-root medical institutions, especially replacement of medical equipment, and more purchase of newer and more complete medical equipment. Meanwhile, the number of beds should be increased according to location of primary medical institutions and changes in population structure, so that patients can receive proper diagnosis and treatment there. Secondly, to guide medical graduates to work in primary medical institutions. National and local governments have given policy preference in salary and promotion to encourage newly graduated medical students to work in grass-root medical and health institutions. Meanwhile, efforts should be made to guide primary medical institutions and medical universities to establish internships and training bases, and to allow medical college students to exercise and improve in primary medical institutions.
Thirdly, to increase training and guidance for grass root medical technicians. It is advisable to activate the internal vitality of grass-root medical institutions, to improve medical level and service capabilities of technical personnel, and to send them to universities or famous hospitals for training and learning on a regular base. At the same time, some well-known medical experts should also be invited to provide guidance and assistance to primary-level medical and health institutions, so as to improve the level and ability of professional and technical personnel in grass-root medical and health institutions.