| Shanghai is one of the places that relatively centralizes the medical and health resources in China.The outpatient number in Shanghai medical institutions jumped to 258,346,200(258.3462 million)in 2014 from 202,053,000(202.053 million)in 2011.The number increased by 56,293,200(56.2932 million),an increase of 27.86% in three years.The number of hospitalizations increased from 2,680,200(2.6802 million)to 3,451,100(3.4511 million),an increase of 28.76%.In addition,the number of non-Shanghai natives seeking for medical treatment was growing.The hospitalization rate of non-Shanghai natives is 22%、25%、28% from 2012 to 2014,which demonstrates that the capability of medical service in Shanghai is developing as Shanghai is the leading city in aspect of medical technology and service.However,problems of difficulties in seeing a doctor remain,mainly including difficulties in getting an appointment with specialist and difficulties in illness recovery.In 2012,approved by the relevant department,the urban TCM hospital-Jingan healthcare alliance,the first one advocating the Chinese medicine was jointly set up.Its core is Shanghai Hospital of Traditional Chinese Medicine,grouped by Jingan Hospital of Traditional Chinese Medicine,9 community health service centers in Jingan district,and the department of TCM in secondary-level comprehensive hospitals in Jingan district.The first implementation of the urban TCM hospital-Jingan healthcare alliance is to offer the general diagnosis down to grass-roots medical institutions,classification of medical treatment and the dual referral to the patient.Hospitals of the healthcare alliance construct the medical net work,where information can be transferred and shared.Practice of the doctor multi-sited license in the healthcare alliance can promote health personnel interact with each other and lead the high quality medical resources to the grass-roots hospitals.A medical source platform is established to achieve information sharing and expert appointment.The medical institutions in the healthcare alliance cooperate with each other to cultivate the TCM talents.Although the TCM hospital healthcare alliance has made remarkable achievements,the results of carrying out classification of medical treatment,results inter-accreditation and TCM characteristic development fall short of what we have expected.There are no subordinate relations between medical institutions in the healthcare;they have respective management,performance reviews and large differences in personnel structure.And people are concern about the treatment level of community hospitals whose service capability is insufficient.That’s why classification of medical treatment in the regional healthcare alliance can hardly play its role and there’s definitely room for improvement.Different investment of equipment and medical quality control management between medical institutions lead to the limited coverage of results inter-accreditation.Government investment,performance evaluation mechanism and different salary lead to that the talent flow is confined to practice of multi-sited license.The scientific research talents and disciplinary teams fall far behind,so there’s no breakthrough on the scientific research project and the high level discipline construction.With the rise of healthcare alliances all over the country since 2014,there are increasingly loud calls for objective evaluation and development research on healthcare alliances,which has become one of the most urgent projects of public management theory and hospital management theory in our country.As a new medical service mode,the flourishing healthcare alliances completely and deeply promote the medical reform,but also bring historic challenges to the government policy guidance,the financial investment and the medical service ability.Concerning the management of healthcare alliances,it is still on the groping stage for our country,which not yet form a new replicable and sustainable medical service mode.At present,there are some deeper reasons that the development of healthcare alliance has problems.And the urgent problem facing the healthcare reform in our country is how to set up the well-functional healthcare alliance. |
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