Study On The Optimization Of Family Doctor System In Shanghai Suburbs

With the deepening of the new round of medical and health system reform,the family doctor system as an important part of the reform of Shanghai’s primary medical and health service system has received widespread attention from the society.The purpose of promoting the family doctor system is to make family doctors the mechanism of "dual gatekeeper" of residents ’health and medical insurance funds,so that residents’ medical insurance funds can be used rationally and reasonably,while reducing medical expenses and improving residents ’health status,so that residents’ Personalized health needs are met,let family doctors become custodians of residents’ health,managers of health funds,and allocators of health resources,effectively improve the current problem of "expensive and difficult to see doctors",effectively improve residents’ health awareness,and reverse "heavy doctors" The traditional concept of "light defense" further enhances residents’ satisfaction and sense of gain.Shanghai first piloted the family doctor system in 10 districts including Pudong,Changning,and Xuhui in 2011,and it has been promoted throughout the city.With the launch of a new round of comprehensive community health service reform in Shanghai in 2015,the supporting policies for the family doctor system have been further improved,but there are still many problems in the implementation andpromotion of the family doctor system in the suburbs compared with the urban area ofShanghai,mainly It is reflected in three aspects: low contract rate of family doctors,difficulty in implementing graded diagnosis and treatment services,and low health management coverage rate of contracted people.These problems directly restrict the promotion and development of the family doctor system in the suburbs,and have a certain impact on the health protection of suburban residents.This article takes Qingpu District,a suburb of Shanghai as an example,through analysis and research on the implementation of the current family doctor system in Qingpu District to find out the dilemmas and constraints faced by the implementation of the family doctor system in the suburbs,and proposes optimization suggestions.There are four parts in this paper.The first part describes the background and significance of the topic.At the same time,through the analysis of relevant literature at home and abroad,the research goals of this paper are proposed,the research content and research methods of this paper are briefly explained,and the innovations and points of this paper are proposed.The shortcomings;the second part mainly elaborates on the development of the Shanghai community health service system and the formation of the family doctor system and how the suburbs have evolved from the rural doctor model to the family doctor model;the third part introduces the geographical population of Qingpu District and the distribution of health resources.The analysis of the status of contracting with family doctors,the status of graded diagnosis and treatment services,and the health management services of the contracted population shows the current status of the implementation of the family doctor system in Qingpu District;the fourth part analyzes the survey data in detail through questionnaire surveys and using SPSS19.0 The constraints of the implementation of the family doctor system in the suburbs are mainly reflected in six aspects: 1.The family doctor system is not well publicized,2.The contract coverage of the key population is low,3.The supporting policies for signing and grading diagnosis and treatment are unattractive,4.The community health service center haslow trust,5.Residents’ medical habits need to be properly guided.6.Health management services for contracted people need to be strengthened.The fifth part is the combination of the third part of the Qingpu District family doctor system implementation status and the fourth part of the constraints summarized from the community health service center level and government level to propose six aspects of feasibility optimization: 1,the effective use of rural doctor team,2.Strengthen the construction of the family doctor team.3.Optimize the family doctor team salary distribution system.4.Widely publicize the family doctor system.5.Improve the family doctor contract and graded diagnosis and treatment supporting policies.6.Support from superior authorities.