The Research On Efficient Downward Transfer Structure Of Health Service Demand In Shanghai

The downward transfer of health service demand is directed at the structural disparity between demand and supply in the public health system. The community health service centre and hospital have different advantages in supplying basic health service and curing tough troubles, so it will be efficient to deal with both of them. However, according to the chronic factor, hospitals always the first choice for patients in Shanghai no matter what kind of service is needed. Therefore, we have to analyze the situation and devise a reasonable structure for the health system, which can make the basic health service transfer downward to the community health service centre, making good use of all the health resources.This thesis is composed of four main parts. The first part illustrates the situation of Shanghai's basic health service system and points out the main problem of it which is due to the structural disparity between health service supply and demand. If the patients can be leaded to transfer to community health service centre for the basic health help, hospitals can have more time for the advanced research and bring more benefit for patients. The second part analyzes the methods applied in other cities'health reform and also finds that these methods can't be used efficiently in downward transfer of Shanghai's health service demand. So in the third part, the key point of three different mechanisms in three countries is acquired and also gives useful information about how to realize the downward transfer indeed during the research. The last part is the result of all the above study and analysis. I get the new operating structure of the health system is devised, including relationship between health institutions and patients, relationship between different health institutions and relationship between medicare fund and health institutions. After the structure is put forward, advices about how to make this transfer become true are followed. If the new structure can be brought into the health system, community health service and hospital service will be provided to different level patients, making their advantages. This will cut the health fees of the whole society and let more patients benefit from the wasteful health expense.This thesis is based on careful study of demonstration information and a lot of objective data, so it has certain reference value theoretically and practically. And it can be helpful for the reform of Shanghai health system.