Investigation On The Development Of Primary Medical Institutions In Chengdu Under The Background Of Classified Diagnosis And Treatment

Objective In Aug,2016,The National Sanitation and Health Conference puts HMS(hierarchical medical system)on top priority among five basic health care systems in China.Currently,HMS has been regarded as an effective approach for cracking dilemmas of New Medical Reform and already been implemented in China.On the basis of organizing national,provincial and municipal relevant rules and regulations,the paper takes primary health-care institutions in C hengdu as research objects and attempts to realize their development status by systematically and comprehensively analyzing their development status in C hengdu in 2011-2015.Concurrently,the paper implements HMS cognition degree survey on doctors in community health service center to realize HMS cognition situation among doctors.Through these procedures,the paper mainly focuses on the dilemmas and obstacles in the process of implementing HMS,at the same time put forward corresponding countermeasures and suggestions as references for further establishing complete HMS.Methods Document Analysis Method: by collecting pertinent rules and regulations and periodical literatures about HMS,realizing its temporary research trends;Questionnaire Method: launching the questionnaire on doctors meanwhile using statistical methods such as statistical description and chi-square test to analyze questionnaire data;Interview Method:interviewing health administrative departments’ leaders for the purpose o f understanding helpful practices and experiences in the path of carrying out HMS;adopting Topsis and RSR methods and its ambiguous combination between each other to comprehensively assessing primary health –care institutions’ development status in C hengd u.Results Despite experiencing increase on institution,sickbed,health and family planning staff numbers in primary health-care institutions in Chengdu,but its rate still far behind compares to hospital increase rate;due to limited service capability o f doctors in primary health-care institutions and the influences of essential medicine system and primary diagnosis and treatment environment,residents seldom utilize health services of primary health-care institutions thus exists health resources unused in primary health-care institutions.As it shows from the questionnaire involving doctors that of them hold expectations toward HMS and believe it’s rational to guide patients to achieve primary diagnosis;however there is still a necessity in improving the understanding about HMS and its meaning among patients and it requires further doctor-patient propaganda;both of them support the establishment of stabilized relations between major hospitals and primary health-care institutions to strengthen the implementation of hierarchical diagnosis and treatment;but HMS advances slackened by various reasons such as the lack of benefits allocation 、detailed interpretation of hierarchical diagnosis and referral between different medical institutions 、 insufficient support from medical insurance and conventional consciousness of seeking a doctor of residents.Suggestions(1)fasten supply-side reform toward health resources of primary health-care institutions;(2)adopt diverse measures to enhance health service ability of primary health-care institutions and utilization efficiency;(3)manifold approaches to conduct hierarchical diagnosis and treatment propaganda and boost participation ratio of doctors;(4)accelerate payment ways’ innovation of medical insurance and increase its management standard(5)grasp the opportunity of “internet+medical” to realize information sharing between different medical institutions;(6)adjust reasonably the benefits allocation between different medical institutions to heighten the participation ratio of medical institutions;(7)devise impeccable detailed implementation interpretations of hierarchical diagnosis and treatment to achieve orderly referral;(8)intensify the construction of medical consortium to perfect the realization pattern of hierarchical diagnosis and treatment;(9)reinforce the popularization of medical knowledge to transform conventional consciousness of seeking a doctor.