Research On The Implementation Deviation Of Graded Diagnosis And Treatment Policies Of The Tertiary Hospitals In Yunnan Province

The policy of grading diagnosis and treatment is an important public policy proposed by the state to solve the contradiction between the growing medical needs of the people and the limited quality medical resources.In the "Guiding Opinions on Promoting the Construction of Graded Diagnosis and Treatment System",the state has positioned the tertiary hospital as a regional critical and critical care clinic,medical technology research center and medical talent training base.However,there is a big deviation between the practice of the tertiary hospitals in Yunnan Province and the policy orientation of the regional critical and critical care clinics.The policy orientation has not been implemented.Using stakeholder theory to identify stakeholders who influence the implementation of the grading diagnosis and treatment policy as governments,tertiary hospitals,primary care institutions,patients/residents.Through the analysis of the stakeholders' interest demands,five reasons leading to the deviation of the policy orientation of tertiary hospitals in Yunnan Province in practice are obtained.First,there are deficiencies in the formulation of graded diagnosis and treatment policies;Second,there are deviations between the strategic positioning by tertiary hospital administrators and the policy positioning of tertiary hospital;the third is that the medical staff in tertiary hospitals have low willingness to implement the grading diagnosis and treatment policy;the fourth is the insufficiency of medical service capacity of the primary medical institutions;and the fifth is that the patients are more inclined to go to the tertiary hospital for medical treatment.In order to promote the implementation of the policy orientation of graded diagnosis and treatment in the tertiary hospitals in Yunnan Province,at the government level,we should improve the benefit distribution mechanism of the graded diagnosis and treatment system from the aspects of reforming the medical insurance policy,further adjusting the price of medical services,exploring the profit distribution mechanism of the medical association,and further improve the graded diagnosis and treatment assessment criteria;at the level of tertiary hospitals,we should further standardize the value guidance,and drive the transformation of tertiary hospitals;at the level of primary medical institutions,through the investment in infrastructure construction of primary medical institutions,the establishment of high-quality physician teams in primary medical institutions and the full play of the role of “Internet +” to improve the medical service capacity of primary medical institutions;at the patient/resident level,we should change the concept of medical treatment by guiding patients to go to hospital at different levels,strengthening the publicity and education to the masses.so as to ensure the realization of the goal of the graded diagnosis and treatment policy.