Research On The Problems Faced By The Implementation Of The First Diagnosis System At The Grassroots Level In The Western Minority Areas

Since the reform of China’s healthcare system in 2009,pilot work on primary care in different ways has been carried out across the country,to establish a scientific and reasonable order of access to healthcare at each level.The Alxa League in Inner Mongolia has also followed the pace of the reform by forming a medical association,differentiated payment of medical insurance contributions,establishing a referral system and forming a team of general practitioners,to cultivate the local urban and pastoralist residents to form the habit of seeking medical treatment at the primary level.The problems of disorderly access to health care and the low level of primary care services have been highlighted.Therefore,we need to investigate the allocation and distribution of primary healthcare resources,the level of supply of primary healthcare services,the use of primary care by residents,and the awareness of primary healthcare workers about the implementation of the primary care system in Inner Mongolia’s Alxa League,to analyse the problems faced by the implementation of the primary care system in Inner Mongolia’s Alxa League and to propose countermeasures for the maturation of the primary care system in the western ethnic regions.Based on the theory of supply and demand equilibrium,this paper examines the problems faced by Inner Mongolia Alxa League in the implementation of the primary care system from both the supply and demand sides.Firstly,the statistical yearbook of health and family planning of Inner Mongolia Alxa League(2017-2019)was collated and analysed to grasp the construction of primary health care institutions in Inner Mongolia Alxa League.Secondly,from the demand side,610 residents of Alxa League were selected using questionnaires to investigate their basic personal information,self-assessed health and chronic disease prevalence.Again,from the supply side,324 medical personnel were selected,also by questionnaire,and surveyed on their personal information,knowledge of the primary care system,and in-depth interviews were conducted with selected persons in charge and relevant knowledgeable persons.Finally,the quantitative data were statistically analysed using SPSS 22.0 and the qualitative data were collated and analysed using content analysis.Conclusions were drawn: Firstly,the residents of Alxa League have low utilisation of primary care,insufficient knowledge of relevant health policies,lack of regional characteristics in guiding local residents to primary care,and the disadvantage of contracted family doctor services,technical level and equipment conditions;secondly,the awareness of the primary care system among primary health care personnel in Alxa League is insufficient,the guiding role of strategies related to primary care has not been fully played locally,and the primary The technical level of medical personnel is generally low,and primary health care institutions are unable to reflect the advantages of the primary care policy due to poor accessibility.Based on the results of the study,we propose countermeasures and suggestions for promoting the primary care system in the western ethnic areas,taking into account relevant theories: firstly,to do a good job of top-level design with local characteristics,to do a good job of planning the development of primary medical and health care,to strengthen the construction of basic medical facilities in,for example,pastoral areas and other areas with a relative lack of medical resources,and to establish a long-term operating mechanism for the service system in remote areas;secondly,to promote the implementation of policies with geographical characteristics,to enhance the accessibility and geographical advantages of primary Third,create a service model that meets the health needs of urban and pastoralist areas,explore the new service model of "Internet + small medicine box",strengthen policy publicity and guidance,cultivate the concept of primary care for residents and popularise family doctor contracting services;fourth,optimise the talent pool and To improve the level of grassroots medical and health services,improve the treatment and quality of grassroots medical personnel,stabilize high-quality grassroots talent,and establish an adequate number of high-quality general practitioners.