The Analysis And Discussion On Grading Medical In Public Hospitals Of Yangzhou City

Objective:The purpose of this study is to configure from the three aspects of health resources and describe the current status of medical grade Yangzhou utilization, two-way referral status quo and the status quo of community first diagnosis, combined with interviews and qualitative data, for Yangzhou grading clinics Yangzhou situation and hinder the formation of a reasonable classification treatment model factor model is proposed to improve its strategy and policy recommendations grading clinic building.Method:The main source of information four channels of this study:(1) literature. Collection of national and Yangzhou City, Jiangsu Province, reform of public hospitals policy document, 2009- Yangzhou City Health Profile 2014 Statistical Yearbook, and Pub Med, Articles, China and other journals database how net theoretical research.(2) interviews. To a Health Department staff, two leading three hospitals, two district hospitals and six community hospitals leadership leadership clinics for grading the status of implementation, difficulties and improvements in the implementation of qualitative research.(3) on-site investigation. Yangzhou City, two large public hospitals, doctors and patients two district hospitals and five community hospitals two-way referral and community first diagnosis investigation.(4) statistical analysis. Use SPSS software for health resource allocation and use descriptive analysis;physician referral patients both on two-way data descriptive analysis,chi-square test univariate and multivariate Logistic regression analysis.Results:The results of this study is mainly on four aspects:(1) the allocation of health resources in Yangzhou city, level 2 and above hospitals on the number of institutions, the beds and the number of health personnel all have obvious growth, the growth rate of 10.53%, 39.15%, 42.37%, grassroots medical and health institutions and health workers have decreased significantly, the loss of 12.81%, 6.64%respectively, the beds have a modest growth, growth rate of 0.02%, the town of absolute number of grassroots medical institutions and health resources allocation growth, the township medical institutions cuts the number of absolute allocation of health resources.(2) the health resources utilization, level 2 and above of the total number of visits,hospital and hospital sickbed utilization rate has the obvious growth, growth rate are53.31%, 80.64% and 53.31% respectively, grassroots medical and health institutions, the total number of visits, hospital sickbed utilization rate and also to have certain growth,growth rate are 20.68%, 11.05% and 20.68% respectively, the town of grassroots medical institutions and health resource utilization is much higher than the township medical institutions of health resources utilization.(3) the Yangzhou two-way referral doctors, level 2 and above hospitals two-way referral rate was 17.9%, among them, the referral rate was 2.05%, down up referral rate was 15.85%, the basic-level hospitals two-way referral rate was 3.31%. Among them, the referral rate was 0.7%, down up the referral rate was 2.61%, down referral difficulties is one of the major problems of two-way referral. Level 2 and above of two-way referral hospital doctors cognition degree is lower than the basic-level hospital doctors cognition,among them, the publicity and influence the doctor’s income is secondary and above hospital doctors referral down the will of the main factors.(4) two-way referral of patients of Yangzhou, two-way referral rate was 13.04%, the referral rate was 11.46%, up down the referral rate was 1.58%, down referral difficulties is one of the major problems of two-way referral. Patients to community presence for the first diagnosis was 15.8%, the swot analysis of two-way referral was 20.6%, in hospitalized choice, diagnosis and treatment level is the main factor was hospitalized choose to level 2above hospitals, medical convenience is the main factor of patients choose basic-level hospitals. Turn under the types of patients and save medical costs are the main factors influencing the patients turn to under.Conclusion:The main conclusions of this study there are four aspects:(1) re-allocation of health resources in rural city of light, the growth rate of urban health resource allocation is much higher than in rural areas.(2) Health Resources Utilization secondary and higher hospital is higher than the hospital, secondary and higher utilization of health resources in hospitals is much higher than the primary hospital.(3) low-level two-way referral, where the referral is the key down, two or more doctors on cognitive processes and two-way referral criteria under low and turn the weak sense is the impact of dual referral reasons.(4) low level of community first diagnosis, grass-roots hospitals, health care facilities and services is the main reason behind, first diagnosed in patient community awareness and recognition of low degree hindering community first diagnosis of the main reasons.Therefore, to carry out public hospitals Yangzhou classification clinics need from the government’s point of view, a clear medical institutions at all levels and their specific range of medical functions, step up publicity efforts to change public and the traditional concept of a doctor for medical treatment habits, promote health and more conjoined development of a variety of kinds of modes, the eventual establishment of a community-based system of first diagnosis, two-way referral system as a way of reasonable classification treatment pattern.