Obstacles And Countermeasures For Implement System Of First-treatment And Two-way Referral In The Community, Fujian Province

Objective: At present, it is very important to establish and improve the system of first- treatment and two-way referral in the community, rational and effective use of health service resources. This object of study is aim to region in Fujian province, analysis main obstacles which restrict the implementation the system of firsttreatment in the community and two-way referral, and also draw lessons from foreign advanced experience, put forward countermeasures to get rid of obstacles.Methods: The obstacles were found through literature analysis, questionnaire survey. Regarding first- treatment in the community and two-way referral medical treatment, the opinions and suggestions were collected through interviewed with staff from Primary Health Service Institutions, General Hospital, community residents in Fujian province. In addition, we learn the advanced experience from grading-diagnosis in Sweden through field visit.Results: Now, there are six main obstacles in Fujian province for implementation system of first-treatment in the community and two-way referral medical treatment:(1) Policies Guidance: mainly reflects in the medical insurance system, national basic drug system.(2) System Design: mainly reflects in the interaction between first-treatment in the community and two-way referral medical treatment.(3) Key technology for operational mechanism of grading-diagnosis: mainly reflects in the lack of standardization, supervision, evaluation and stimulation(4) Human Resources: mainly reflects in the lack of general practitioners in the community.(5) Information Sharing: mainly reflected in the insufficient of health information sharing system.(6) Publicity and Education: mainly reflects in the willing of patients for seeking medical advice by two-way referral treatment.Conclusion: according to the above obstacles, this study put forward the followingsuggestions:(1) to introduce incentive policies and guidance for implementation of two-way referral medical treatment.(2) to make step by step implementation of the first-treatment in the community, and promote the patient compliance with it.(3) to strengthen institutional improvement and improve the work efficiency.(4) to optimize operational mechanism, and strive to connect seamlessly.(5) to speed up talent construction, and strengthen service ability.(6) to utilize the network technology, and promote information sharing.(7) to intensify propaganda, and change the concept of medical treatment.