Surveillance for Use of Healthcare Services among Residents in Jiangsu Province
**Background:** The improvement of the population's health conditions is determined not only by the investment level and allocative efficiency of health resources, but also by effective utilization of health services by residents. Effective utilization of health services is defined as the number of health services utilized by those demanding it. Results are mutually constrained owing to the interaction between requisite amounts of population health services and the supply of health resources. However, currently, there is an unequal relationship between the supply and utilization of health services, representing the major discrepancy between data reported by the medical health institutions and the data from the population investigation.
The National Health Services Survey (NHSS) has been done at 5-year intervals since 1993 in China, which is an important medium for providing healthcare information of Chinese population. It objectively reflects the achievements and problems during the creation and development of the health service. It also has the potential to predict the changing trends of both demand and utilization of health services. However, the investigation did not reflect the behaviors of health service utilization as expected. The first reason for this is that there is a five-year gap between each National Health Service investigation. This time window is too long, such that it cannot reflect the dynamic trend of the service utilization behavior with sufficient granularity. Therefore, the data cannot justify the need for service development during the time window. Second, the National Health Service investigation is a comprehensive investigation manipulated on a national level. The research and implementation plan to monitor residents' health service utilization behaviors are parts of the investigation. These are unlikely to be adequately specific and detailed. In addition, it is difficult for the investigation to comprehensively reflect the situation and changing trend of the residents' health service utilization behaviors.
Moreover, according to recent literature, differences exist among residents' health service utilization behaviors because of different social statuses and income levels. However, regardless of the aspects, degrees, and factors that characterize this difference, there are no broadly accepted empirical investigations or systematic analyses recognized by the Health Administrative Departments or the academia.
**Research Question:** What are the health service utilization behaviors among the residents in both rural and urban area? How to explore the methods to monitor health service utilization behaviors?
1. By monitoring health service utilization behaviors, we can thoroughly understand information about residents' treatment processes and actions toward diseases, utilization situations and impact factors of the health services, medical expenses, and reimbursement levels, etc. At the same time, to explore and optimize the methods to monitor health service utilization behaviors;
2. Dynamically tracking the behaviors of health service utilization, then analyzing and predicting the changing trend of residents' health service utilization, can provide fast and precise information for deepening the reform of the medical and health systems' planning and evaluation in the "12th Five-year Plan", and overall health resources planning in the "13th Five-year Plan";
3. to accelerate effective utilization of medical health resources, promote development of health management in a more elaborate direction, improve management ability, and overall further satisfy health requirements from residents.
The first phase (3 months) field work was done and the report was developed and submitted to the National Health and Family Planning Commission. The second phase (4 months) is in progress. Several manuscripts are under development.
The project tries to provide current and accurate information for deepening the reform of health systems' planning and evaluation; If the approach of monitoring is proven effective, it can accelerate effective utilization of health resources, promote development of health management in a more elaborate direction, improve management ability, and overall further satisfy health needs of residents.
- the Centre for Health Statistics Information(CHSI) of National Health and Family Planning Commission(NHFPC), the CHSI of Jiangsu provincial HFPC, the HFPC of Gusu District and Jinhu County