The Research For The Problem And Countermeasure Of The Contract Service Of Family Doctor Based On The Healthy China's Perspective

The contract service of the family doctor is the paving stone for achieving the goal of national health in 2030.According to the domestic and international experience,the family contract service is helpful to pass on the core work of the medical and health and resources.It is helpful to enhance residents with the sense of gains of the medical and health service variety.It is helpful to achieve the goal of the first time and classification of the diagnosis and treatment in the primary level.Superior contract service of the family doctor can make the family doctors become the gatekeeper of the health of residents and the medical healthcare insurance fund.The contract service of Hangzhou has been selected as the established case in?China health reform development report(2016)?,which is one of the five service modes generalized by the National Health and Family Planning Commission,is not to be neglected for its nationwide radiate and exemplary influence.There is significant importance for the promotion of the sustainable development of the system by analysing the frame structure and implementation results of Hangzhou "integration of the medical,maintenance and nursing care " contract service scheme as well as identifying the gaps during the promotion.It provides ideas for the nationwide promotion of the family doctor contract service.Based on the establish process and feature of the Hangzhou "integration of the medical,maintenance and nursing care",this paper scientifically takes the residents who signed the family doctor contract,family doctors and government as research objects.Throughout the questionnaires from seven districts and eleven community health centres in Hangzhou as well as interview surveys on the staffs from city health development planning commission and the municipal medical insurance bureau,this paper has analysed implementation process of the family doctor service contract and sumed up the achievement of the Family doctor system as follows:widespread of the number of participants,hight awareness rate and satisfaction degree within the signed residents,signed citizens are more willing to go to a community hospital,people enjoy better health insurance policy.Theref'ore,this article combs up the operating mechanism of the family doctor from three aspects.Firstly,the influence to the efficiency and fairness of the medical service by the macroscopic basic health service system.Secondly,evaluate the implementation effect of Hangzhou family doctor service by public policy assessment theory.Thirdly,through microscopic principal agent theory,analyze the cognition and action generated from the process of service development by the family doctor and signed residents.In addition on the issues found from the survey.it puts forward eight countermeasure suggestion in order to improve the family doctor system.1.Strengthen publicity and guidance.build a new medical order.2.Enrich contract content.meet the needs of the masses.3.Improve work efficiency.form a good contract team.4.Break the information island,share medical resources.5.Improve the referral mechanism,smooth two-channel referral.6.Fully prepare types of drugs,set up a smart cloud pharmacy.7.Set up general medical science ease the shortage of family doctors.8.Scientificly setting assessment,improve incentive restraint system.