The Community First-treatment And Two-way Referral Operating Mechanism Of Exploration In Nanan District Of Chongqing

Objective:Through the survey and analysis to the community first-treatment and two-way referral in Nanan District of Chongqing City,the aim is to find out the main problems and operational obstacles to explore the establishment of the community first treatment and two-way referral operating mechanism, promote regional grading health care system-building and also provide the reference basis for the city and even the national implementation of the community first-treatment and two-way referral.In this way the common problems of that the current people have great difficulty in seeing doctors and can't afford the medical treatment can effectively be alleviated.Methods:The subject conducts research and analysis by means of Literature Review and interview to foreign "gatekeeper" system (called the community first-treatment and two-way referral system in our country) development, our country and Chongqing operation of the community first-treatment and two-way referral of background information in orde to definite the research significance. The current situation and major issues on the Nanan District survey of the community first-treatment and two-way referral are researched and analysed, and the basic condition of operating mechanism has got by applying the cross-sectional investigation and questionnaire method. The operating mechanism of Nanan District the community first-treatment and two-way referral is constructed by applying systematic analysis and organizational design. Through the demonstration and discussion by the experts,the depth interviews with the key persons,organizing the relevant experts and important people analyze and demonstrate the operating mechanism and gain the relevant suggestions.Result:Through carrying out the current survey analysis to the community first-treatment and two-way referral of Nanan District,Chongqing City, the main problems existing were as follows:Firstly, the government lacks the overall idea and development project of grading health care system-building on core of the community first-treatment and two-way referral; Secondly, grading medical network system needs further improvement; Thirdly,the integrating service ability of primary health care institutions can not satisfy the demand of medical treatment for the masses; Fourthly,the two-way referral can't go on smoothly; Finally, the low level of regional health information has become the major restricted factor to affect the implementation of the community first-treatment and two-way referral.Conlusion:After learning about the current running situation and the main problems of the community first-treatment and two-way referral in Nanan District, we need establish and improve the integrating operating mechanism of the community first-treatment and two-way referral in order to promote the grading health care system-building.The operating mechanism has been built of the community first-treatment and two-way referral in Nanan District from the five aspects,such as the policy guarantee, running platform construction, organization management, system guarantee and strengthing important link-building. Through the demonstration analysis by the important persons from expert groups, the government relative leaders, and the persons who are in charge of the general hospitals and community health service centers and so on,everyone agrees that the research of the operating mechanism of the community first-treatment and two-way refferal is the requirement to deepen medical and health system reform, and to explore innovative operating mechanism. It is also the effective measure to alleviate that the current people have great difficulty in seeing doctors and can't afford the medical treatmet. It is of great importance. The constructed operating mechanism has integrity,systematization and feasibility. It is really the important reference that the government carries out the grading health care system-building as core of the community first-treatment and two-way referral.