The Optimization Of Two-Way Referral Pathway From The Perspective Of Medical Consortium

With the implementation of the medical consortium policy across the country,the medical consortium in Hubei Province was basically completed at the end of 2019.Although Hubei Province has achieved unprecedented achievements in the medical field,there are also some problems: First of all,the number of outpatients and inpatients in Hubei Province has shown an upward trend in the past decade,and this trend will continue to grow with the increase of the elderly population;Second,the distribution of medical resources among cities and prefectures in Hubei Province is extremely unbalanced.The tertiary grade A hospitals in the provincial capital city are crowded,while the county-level hospitals and community hospitals are not widely available;Third,due to the comprehensive promotion of the basic medical insurance system,the medical insurance funds of Hubei Province will face a dilemma in the future;Finally,as the medical insurance reimbursement increases gradually,the medical insurance premiums paid by residents also increase.And the increased costs will put some pressure on the agricultural and rural population,causing many rural residents to refuse to pay medical insurance fees.Based on the above background,this study collects relevant literature to sort out concepts related to grading diagnosis and treatment and medical consortium.And summarizes the historical implementation of the policy and constructs a theoretical framework of graded diagnosis and treatment and medical consortium.Through a questionnaire survey of medical staff and referral patients in the A County People’s Hospital,TCM Hospital and MCH Hospital of Xiangyang,this study constructs a basic model of two-way referral.The purpose of this study is to explore the process of the occurrence and changes of the Medical complex policy,analyze the achievements of the medical consortium in Hubei Province,and give some suggestions on the problems existing in the medical consortium.At present,the medical consortium signing the two-way referral agreement with the people’s hospital in the county and city has entered the right track.However,the two-way referral agreement signed with the TCM Hospital and the MCH Hospital has basically stalled.The People’s hospitals have strong medical technology,and patients with mild or severe conditions can be properly handled.Doctors and patients in primary hospitals are hoping to refer them upwards,and the comprehensive strength of the TCM hospital and the MCH hospital cannot meet their needs.Since the referral from within the Medical complex the same as the reimbursement policy enjoyed by the residents of the city on their own,many patients go directly to the people’s hospital,which invalidates the Medical complex led by the TCM Hospital and the MCH Hospital.Based on the above situation,this study puts forward a series of measures to optimize the existing referral path and solve the problems encountered by the medical consortium led by TCM Hospital and MCH Hospital.This study suggests that hospitals can formulate hierarchical diagnosis and treatment standards,allow patients to make reasonable referrals under the criteria of hierarchical diagnosis and treatment,optimize the existing single referral path,and provide patients with more appropriate referral services.Basic-level hospitals should give patients reasonable advice based on the patient’s condition according to this standard,and classify patients at the grass-roots level.Those who fall within the scope of the People’s Hospital will be referred to the People’s Hospital,and those within the scope of the Chinese Medicine Hospital will be referred to the Chinese Medicine Hospital.In addition,it is necessary to optimize the referral path of two-way referrals,so that TCM Hospital and MCH Hospital can effectively assume the responsibilities of the leading unit of the medical consortium,and solve the difficulties encountered by the medical consortium led by TCM Hospital and MCH Hospital.