Study On The Influence Of County Medical Community On The Medical Service Ability Of Township Health Centers

Objective:This study took the township health center of Guilin city as the main research object,understood and sorted out the development status of the county medical community in Guilin area,discussed the impact of the county medical community on the medical service ability of the township health center,and discussed the development bottleneck and prospect of the medical community at the present stage.It provides strategic basis for improving the health service ability,promoting the integration of the county medical and health system and implementing the hierarchical diagnosis and treatment system under the county medical community model.Methods:Qualitative and quantitative studies such as literature review,in-depth interview and cross-sectional survey were conducted to understand the current situation of the reform of the county medical community in Guilin city.One factor analysis and multiple factor analysis models were used to discuss the impact of the hospital community on the improvement of the medical service ability of township health centers.The difference difference model was used to study the changes in the medical service level of township health centers before and after the construction of the county medical community.Put forward the strategy of improving health service quality under the county medical community model.Results:1.Univariate analysis and multiple linear regression showed that there was significant correlation between the total number of patients in township health centers in the construction of county medical community and the dispatched technical experts,the number of patients transferred,the number of telemedicine image diagnosis,and the number of remote consultations(P<0.05).There was significant correlation between the number of discharged patients and the dispatched technical experts,the number of up-transfer patients and the number of remote ECG(P<0.05).2.Findings of the Difference in Differences model: Based on the panel data of 54 township health centers in 6 counties of Guilin from2018 to 2021,the medical service capacity of township health centers before and after the implementation of the policy was compared according to the development of the county medical community.The construction of county medical community had a significant impact on the total number of patients diagnosed and discharged in township hospitals,and was positively correlated with the total number of patients diagnosed and discharged.The did coefficients of the interaction term were 0.2659 and 0.6100,respectively,and were statistically significant at the 5% confidence level.Among the control factors,total medical income,financial appropriation income and total medical expenditure are positively correlated with the medical service ability of township health centers.The increase of income and government investment can improve the medical service level.The improvement of population base and individual level of township health centers has an impact on the improvement of medical service level of township health centers.Conclusions:The construction of county medical community can effectively improve the medical service ability of township health centers.In addition,the positive effects of individual level and external economic development level of township hospitals on the improvement of their medical service ability cannot be ignored.The role of the construction of county medical community in improving the medical service capacity of township health centers cannot be ignored.All localities can strengthen the information construction based on the actual situation to promote the construction of county medical community,improve the medical service capacity of grassroots medical institutions,and gradually promote the construction of the first diagnosis,two-way referral,hierarchical diagnosis and treatment system at the grassroots level,so as to ensure the health of residents.