A Study On The Effect In Hierarchical Medical Of Family Doctor System

Currently,national implementation of the Family Doctor System has promoted the implementation of Hierarchical Medical and solved the livelihood issue called "the difficulty of getting medical service".Focus on Hangzhou which has great economic base and carries out the Family Doctor System for several years.Analysing the actual signing rate of the Family Doctor System implementation of and the actual treatment of the situation in order to understand the current achievements and shortcomings of family doctor service.Compare the choice of health institutions of contract group and the non-contracted group when they facing common disease or seriously to evaluation of the Family Doctor System on the impact of Hierarchical Medical.This paper tries to provide theoretical basis for Hangzhou "medical care integration contract system" and targetes policy recommendations.The study mainly used the literature method,the questionnaire survey method and the interview method.At the macro level,using of "Hangzhou Statistical Yearbook(2010-2016)" and "medical care integration contract system" regular reporting information help to analysis the macro changes which the Family Doctor System brings to basic medical institution.Prove that medical resources sink effect from the perspective of the supplier.At the micro level,in order to understand the medical needs side in the Family Doctor System actual income and feelings,the author random picked448 people in Hangzhou to conduct a questionnaire survey,excluding the current system is still not covered Non-Hangzhou household registration and invalid questionnaires,and finally received 372 valid questionnaires.The descriptive analysis and chi-square test were used to study the choices of different characteristics of the population in the contract signing and using.The interview method further analyzes the satisfaction after signed public see a family doctor and the reasons for system idle.On the basis of this,we chose to use binary logistic regression model to study the effect of contracting on the performance of all the interviewees.Investigating the difference in the choice helps analyze the role of Family Doctor System in Hierarchical Medical from the two major functions of the family doctor-the first choice of diagnosis and treat and the rehabilitation of the disease.After the investigation,although the speed of increase slightly slower than the hospital,the number of primary health care institutions and the number of beds in primary health care institutions have increased year by year after the implementation ofthe Family Doctor System.The annal number of visits on the hospital occupies more than half.From a micro perspective,according to the survey the population of signed slightly less than thirty percent.Signed mainly concentrated in the elderly group,which is the focus of attention of the Family Doctor System at the beginning,but also the highest demand for medical needs.More than 70% of the signed have the family doctor's treatment experience.They evaluate the satisfaction in six factors after treatment.The final score from highest ro lowest is the attitude of family doctor,the waiting time for treatment,the time for treatment,the level of reimbursement,the level of family medical treatment,family doctor services.According to the interview of people who have signed contract but never meet family doctor,no medical needs rank the first reason.Beside this,not accustomed to the family doctor is the second factor.A small number of people expressed concern about the level of family doctors or unclear treatment methods.In order to clarify whether the Family Doctor System has changed the public's choice of medical treatment,this article examines the options of different contract status facing diseases.There is a significant difference in the choice of two types of contract status in the treatment when they face of common diseases such as upper respiratory infection.The probability of the contracted choose the primary health care institutionsl is much higher than the non-contracted.Further study shows that the family doctor have a significant impact only in the some slight common disease(such as gingivitis)and chronic diseases(such as diabetes).Facing pathology complex disease all public are still choose to the hospital.In serious illness the contract status only effect the disease which cause inconvenience(such as stroke).Finally concluded that the implementation of the Hangzhou Family Doctor System has reduced the economic burden for patients and change the options in some common diseases.However,in the future the Family Doctort System needs to develop the content and expand publicity.Improving the family doctor team medical level is also an important part for attract people.Change the stereotypes of primary health care so that the Family Doctor System really promote the Hierarchical Medical.