Research On The Process Of Medical Social Work Intervention In Hierarchical Medical System

The researcher works as a medical social worker in a upper second-class hospital in Shanghai,and is responsible for the promotion of medical social work and voluntary service.The hospital joined the L medical treatment combination in December 2015,so the service scope of medical social work gradually extended from the original "hospital service" to " medical treatment combination service".Hierarchical medical system that involves different levels of hospitals.As a bridge between patients and hospitals,medical and social workers in some domestic hospitals and medical institutions can play an active role that helps to coordinate the relationship between doctors and patients,carry out humanistic care,and promote resource integration.Starting from the origin and practice of medical social work and voluntary service carried out by medical institutions at all levels,this study takes l Medical Association as the research subject,involving a Grade3 senior hospital,a Grade2 senior hospital and five social health service centers,within these seven hospitals as the main research field.By using the methods of participation observation and interview to collect the data related to the research topic,this paper discusses how the medical social work service can play a role in the hierarchical diagnosis and treatment mode of "the first diagnosis at the grass-roots level,two-way referral,differentiate fast and slow treatment,upper and lower linkage".It is found that there are three main ways for medical social work to intervene in hierarchical diagnosis and treatment in L-medical united Association.Firstly,the direct service for patients and residents is the foundation of medical social work intervention.At the micro level,the case management method is fully used.At the meso level,diversified projects are incubated.At the macro level,the linkage and cooperation of community resources are promoted to effectively enhance hierarchical diagnosis and treatment,also the patient's medical experience.Secondly,the linkage between medical social workers and voluntary service is the starting point for medical social work to intervene.From recruiting caring people to cultivating public welfare team to help the construction of the base,the linkage of voluntary service forms a professional team to provide the basis of soft service for the implementation of hierarchical diagnosis and treatment,and create an atmosphere of humanity and love.Thirdly,the indirect service of popularizing the concept and method of social work is an important guarantee.Professional social workers rotate and practice,multi-level training and supervision,continuing education and promotion practice,and medical social work professional services are infiltrated in the medical system of hierarchical diagnosis and treatment.Through the research,we found that the main problems of medical social work intervention in hierarchical diagnosis and treatment are the lack of professional medical social workers,the blurring of the role of social workers,the resistance of medical team cooperation,and the industry barrier of resource integration.Therefore,the researchers put forward three levels of intervention suggestions.In the micro system,we need to build a comprehensive medical and social workers team,accurately grasp the multiple needs of patients,guide and change the concept of medical treatment;in the mesoscopic system,we need to cultivate public welfare culture,promote multi-disciplinary and multi professional cooperation,and encourage cross industry and cross field linkage;in the macro system layer,we need to advocate community health related policies,participate in community public health services,and promote disease prevention Establishment of prevention system.