Investigation On The Implementation Effect Of County Medical Community In Tongren City, Guizhou Province

Objective: To explore the problems and influencing factors in the implementation of the medical community policy in guizhou province by analyzing the implementation effect of the medical community policy in tongren,so as to provide the basis for improving the relevant policies of medical community.Methods: To provide theoretical basis for this study through literature research.The random sampling method was adopted to carry out a sampling survey of the people's hospitals in songtao autonomous county,yanhe autonomous county and sinan county,as well as the large township hospitals subordinate to the county hospitals.The questionnaire and interview outline designed by the research team were used to collect data from relevant parties,such as staff of municipal commission of health and family planning,county bureau of health and family planning,and medical and health institutions at all levels,as well as patients.At the same time,monitoring data of the medical community reform of tongren city commission of health and family planning from 2016 to 2018 were collected,including outpatient visits of medical institutions at all levels,patient flow and the flow of new rural cooperative fund,etc.,and descriptive analysis was conducted by using excel software to discuss the implementation status,initial results and existing problems of the medical community in tongren county.Results :(1)The number of outpatients and inpatients in county-level medical institutions and township medical institutions in tongren increased year by year.The outpatient number of village-level medical institutions decreased year by year,and the number of people visiting counties outside the county increased year by year.(2)The per capita outpatient expenses show a trend of decline year by year.The per capita reimbursement for the outpatient expenses under the new rural cooperative medical care system increased by 4.50 yuan and 5.39 yuan respectively in 2018 compared with 2016.The per capita reimbursement for inpatient expenses under the new rural cooperative medical care system increased by 20.84% and 33.29% respectively compared with 2016.(3)The medical community policy did not prevent the flow of funds outside the county,and the proportion of funds within the county decreased by 6.02 percent in 2018 compared with 2016.(4)The comparison effect between songtao county and sinan county and yanhe county in the medical community pilot county was not ideal.The serious situation of out-of-county medical treatment in songtao county increased by 194.57% year on year,and other indicators gradually tended to be normal.(5)Only 65.86% of medical staff are familiar with the medical community policy,and only 41.00% are very satisfied with the medical community.(6)59.80% of the patients surveyed were satisfied with the implementation of the medical community,and 56.00% felt that the implementation of the medical community was effective.Conclusion :(1)The medical community policy has been implemented in tongren for one year,effectively integrating the medical resources in this area.Medical expenses have been brought under control,the reimbursement rate of the new rural cooperative medical system has increased,and the number of patients in primary medical institutions has increased.However,the order of seeking medical treatment is not stable enough.The situation of seeking medical treatment outside the county is still serious,and the implementation effect of the policy still needs to be further observed.(2)Grassroots medical staff and the masses have insufficient understanding of medical community policies and need further.