Study On The Effect Of The Implementation Of The "Healthcare Alliance" Model Of The Grading Diagnosis And Treatment System

ObjectiveBy sorting out the data of medical and health configuration,health service utilization and dual referral of in the Statistical Bulletin of Health and Family Planning in Shanxi Province from 2009 to 2015,we will investigate about the present situation of the implementation of the grading diagnosis and treatment system in Shanxi Province,analyze the implementatary of the "Healthcare alliance" model of the effect from the fundamental to find out the existence of the problem.To provide reference and develop strategies for the further the implementation of the grading diagnosis and treatment system,we will use new institutional theory related concepts to explain and analyze the study found.Methods(1)Literature analysis.Through the database such as the Chinese network,wan fang database,weipu and PubMed,the key words of " Grading diagnosis and treatment " and " Healthcare alliance " are searched,the relevant literature was retrieved,which was repeated analysis and research to understand the effect of the implementation of the grading diagnosis and treatment system at home and abroad.(2)Comparative study.The selected object are hospital and the primary health care institutions in Shanxi Province,which will be divided into the healthcare alliance and the non-healthcare alliance.By collecting the data in 2009-2015,we will compare the hospital with the primary health care institutions,the healthcare alliance and the non-healthcare alliance by the medical and the health configuration,health service utilization and dual referral to find out the drawbacks of the healthcare alliance model in Shanxi Province.(3)Depth interview.To perfect the research plan,we will interview some people,such as hospital medical staffs,patients and their families,medical school professors and government related personnel.(4)Statistical analysis.Shanxi Province health statistics were collected and analyzed from the Statistical Bulletin of Health and Family Planning in Shanxi Province.And we will use EXCEL2013 to sort out the recovered data,perform statistical description and statistical inference.Results(1)Medical and health configuration: The hospital growth rate was 9.8%,the number of primary medical and health institutions grew by 3.01%.The growth rate of hospital volume is higher than that of primary medical and health institutions.Primary health care institutions bed growth rate(2.61%)was significantly lower than the hospital bed growth rate(36.71%)in the non-healthcare alliance.The number of beds in hospitals showed a trend of slow growth.The number of beds in primary medical and health institutions showed a negative growth trend.The growth rate of bed number of medical institutions(45.01%)in Shanxi was slightly lower than that in hospital(51.30%).The number of health technical personnel in the non-healthcare alliance medical institutions was significantly reduced in Shanxi Province,which the reduction rate was 19.60%,and the medical care ratio decreased from 1: 1.30 to 1: 0.93.The growth rate of primary health care institutions(35.04%)was higher than the hospital growth rate of the non-healthcare alliance(12.36%),and medical care ratio increased from 1:1.04 to 1:1.17.(2)Health service utilization: The growth rate of the non-healthcare alliance medical institutions in Shanxi province and Shanxi healthcare alliance medical institutions(104.4%)was higher than that of hospital(41.48%)in terms of the total number of medical services and the number of outpatient and emergency service providers.Shanxi healthcare alliance was a positive growth trend,but the non-healthcare alliance in Shanxi province showed negative growth trend in 2014-2015 years.The growth rate of inpatients in the nonhealthcare alliance in Shanxi province(53.06%)was slightly lower than that in hospital(68.24%).The growth rate of primary medical and health institutions in Shanxi(122.5%)was higher than that in hospital(58.65%).(3)Dual referral: The downward referral rate was 274%,and the upward referral rate was 23.26% in the non-healthcare alliance,which the community health service centers(stations)were the main centers for upward and downward referral.The downward referral rate was 200%,and the upward referral rate was 49.22% in the healthcare alliance,which the downward referral was mainly to Institutes of health,and the upward referral was based on the community health service center(station).Conclusions(1)The implementation of the policy of the grading diagnosis and treatment in Shanxi Province,the model of the healthcare alliance,has significant effect in the medical and health configuration,health service utilization and dual referral.(2)The healthcare alliance in Shanxi Province has improved the level of basic medical and health services effectively,some health professors retain to stay at the basic health care institutions,which has increased attendance,has improved the efficiency of the use of medical services.(3)The implementation of the dual referral policy effectively promotes patients downward referral,referral population increased year by year,referral system and referral process to be developed and refined.