Research On The Implementation Status,Problems And Countermeasures Of Hierarchical Diagnosis System In Shandong Province

With the implementation of the new round of health system reform,Shandong Province has begun to explore the related work of hierarchical diagnosis system,and formally launched pilot work in 22 counties and cities in Weifang,Dongying,Weihai and other areas in 2015.The goal is to achieve full coverage of counties(cities and districts)in 2016;and to basically build a hierarchical diagnosis system and system in 2017.In 2020,we will establish and improve the hierarchical diagnosis system in line with the actual situation in our province,and implement hierarchical diagnosis system in an all-round way.In order to study the implementation ofhierarchical diagnosis system in Shandong Province,this paper mainly studies the exploration of hierarchical diagnosis system mode in Shandong Province through the relevant security policies and measures for the construction of hierarchical diagnosis system in Shandong Province and the specific practice in the process of promoting hierarchical diagnosis system,and through the analysis of the changes in the allocation and utilization of health resources in medical institutions at all levels in Shandong Province,as well as the health of medical institutions at all levels.The change of resource utilization efficiency is used to evaluate the operation of hierarchical diagnosis system in our province as a whole.According to the overall implementation status of hierarchical diagnosis system,the existing problems and their causes in the implementation of hierarchical diagnosis system in our province are analyzed.Finally,suggestions for improving the hierarchical diagnosis system are put forward,which provides policy basis for the decision-making of relevant departments in our province.In the course of this study,we use literature analysis to summarize the concepts and policies related to hierarchical diagnosis system in Shandong Province,and summarize the implementation of hierarchical diagnosis system at home and abroad;use case analysis to introduce and analyze the typical cases emerged in the practice of graded diagnosis and treatment model in Shandong Province in recent years;and combine the relevant data of health institutions in Shandong Province to introduce and analyze Shandong Province.Descriptive analysis was made on the allocation of health resources and utilization of health services in medical institutions at all levels,and DEA-Malmquist index model was used to calculate the utilization efficiency of health resources in medical institutions at all levels in Shandong Province since the new medical reform.It is found that there are some problems in the implementation of hierarchical diagnosis system in Shandong Province,such as imperfect supporting policies,inadequate implementation of contracted service model between medical associations and family doctors,unreasonable allocation of resources in medical institutions at all levels,wide gap in utilization of medical services,unreasonable patient graded treatment and so on.Since the implementation ofhierarchical diagnosis system,the resources of township hospitals and community health service centers in Shandong Province have been unreasonable.Utilization efficiency is only slightly improved by technological progress.At present,the overall utilization efficiency of health resources in our province has not shown a continuous improvement.In the short term,the overall implementation effect of hierarchical diagnosis system is not significant.In view of the problems existing in the implementation of hierarchical diagnosis system in Shandong Province,this paper makes an analysis of the causes from three perspectives of institutions,patients and the government,and puts forward suggestions on perfecting the graded diagnosis and treatment system in Shandong Province,improving the health service capacity of primary medical institutions,improving the linkage mechanism of hierarchical diagnosis system,and optimizing the input structure of health service resources in medical institutions at all levels.