Study On The Path Of Infertility Prevention And Treatment Based On Hierarchical Medical System

ObjectiveThis research relies on the successful experience of hierarchical medical system practice of three years of infertility prevention and treatment in YY.It studies and analyzes the application of hierarchical medical system ideas in the field of infertility prevention and treatment.Based on the theory of social division of labor,it summarizes its operation mechanism and related support,and discusses its benefits and expandability,provide case evidence for infertility prevention and treatmentbased onhierarchical medical system,and build a path for infertility prevention and treatment based on innovative care for chronic conditions framework(ICCC).Methods(1)Literature method:use CNKI and Springer Link to search the related literatures on"infertility" and "hierarchical medical system" to understand the current status of infertility and hierarchical medical system;(2)Interview method:use in-depth interviews and structured interviews to interview the administrative department,medical institutions,doctors and patients,to understand policy support,hierarchical medical system,the composition of the helper team,the behavior and experience of patients,and the use of hierarchical medical system;(3)Questionnaire method:use telephone to investigate the demographic characteristics and diagnosis and treatment behavior of the infertile couples who actually participated in the treatment,and collected 209 effective questionnaires;(4)Statistical analysis method:collect physical examination data and use SPSS to analyze the characteristics of the infertile couples.Combined with outpatient data,follow-up data and questionnaire data,the characteristics and diagnosis and treatment behaviors of the pregnant women were analyzed.ResultsIn the analysis of physical examination data,it was found that the age of infertile women was higher than that of the general population,the proportion of hypotension and overweight was higher,the history of abortion was higher,especiallyartificial abortion,and the gynecological health status was poor.The performance of non-child women in infertile women is similar,except that the rate of dysmenorrhea is significantly higher than that of the general population.Through correlation analysis,it was found that the successful pregnancy support group was older and had large age difference between couples,as well as higher education level,more frequent outpatient treatment,and more use of assisted reproductive technology.Subjects who are more active in seeking medical care have higher referral rates,and those with more frequent outpatient visits have higher acceptance for downward referrals."Action for infertile couple" based onhierarchical medical system is convenient accessibility,continuous full-course prominence,low medical expenses,and reduced blind medical treatment for patients,through demand survey,health checkup,expert consultation and follow-up,etc.Indeed,follow-up and psychological support from doctors plays an important role.According to the "structure-process-result" evaluation model,the evaluation of action for infertile couple was evaluated from structural evaluation,process evaluation,result evaluation and stakeholder-driven situation.The overall benefit was good and the driving force of all parties was clear.However,there are some lack of referral criteria and assessment indicators.Based on practice,the framework of infertility prevention and treatment was constructed with ICCC.The three levels were discussed,and the prevention and treatment path based on individual infertility was given and described.Finally,the possibility of establishment and generalize of the path was carried out by SWOT analysis."Action for infertile couple" needs to further publicize the action,continuously improve technical strength,improve inspection accuracy,standardize referral criteria and referral procedures,formulate more specific grassroots team training plans,and improve performance appraisal and progresssupervision.For infertility graded diagnosis and treatment,we need to attach importance to leadership support,strengthen publicity and education,strengthen team building,adhere to follow-up,standardize referral procedures,improve information construction,optimize birth policy,attach importance to assisted reproduction,strengthen health education,and provide fertility counseling.