The Study Of The Work Division And Coordination On Chronic Disease In Typical Areas

Objective:Based on literature review of the connotation on medical institutions' coordination,this research builds the framework of chronic disease's coordination.By analyzing it through typical areas and summarizing the characteristic experience,this thesis aims to support suggestion on the management of chronic disease and hierarchical medical system.Contents:Content one:summarizing relevant theories of medical institutions' coordination and chronic disease's management as research basis.Content two:detailed analysis of the following six parts:background,management coordination,service coordination,human coordination,information communication and financing and motivation.Content three:comparison among different research areas.Content four:characteristics and experience summarization for management of chronic disease and hierarchical medical system in our country.Method:Literature review is used to analyze the connotation of medical institutions and the framework of chronic disease.Inductive analysis is used to make the conclusion.Investigation in typical areas,mainly by interview and questionnaire survey,is used to collect related materials.Case study is used to make a deep summarization.Results:Both Zhenjiang and Changzhou have made some measures to improve the chronic disease's coordination in medical institutions,such as to set up a relevant management institution,to definite different medical institutions,to popularize the service mode of general practitioner,and so on.On policy aspect,Zhenjiang and Changzhou have the similar reform background,but Zhenjiang has a longer reform history,which gains more experience.On management aspect,Zhenjiang's depth and width of reformation are better than Changzhou.On service aspect,both Zhenjiang and Changzhou aim to achieve the longitudinal coordination by setting up health alliance system and popularizing the service mode of general practitioner,but Zhenjiang has a clearer chronic referral standard.Conclusion and Suggestion:Based on literature review of the connotation on medical institutions' coordination,this research builds the framework of chronic disease's coordination from the following six parts:background,management coordination,service coordination,human coordination,information communication and financing and motivation.Then make a detailed analysis and comparison between Zhenjiang and Changzhou.Conclusions are made as follows:rich reform experience and loose political environment contribute a lot in coordination work.Rational division of medical institutions is the base and foundation of work.Direct management department is the catalyst.In addition,our government and medical insurance's dynamic effect should be used.Nowadays,the most challenge among medical institution is the imperfection of interest coordination mechanismSuggestions are made according to this research.Strengthen government guidance,and expand the implementation scope of the close-type medical service collaboration.Relevant job training and policy support should be made to perfect the family doctor system.Proceed the payment reformation of medical insurance to improve the interest allocation mechanism and motivation of medical institutions.Furthermore,medical information construction should be strengthened.