Study On The Optimization Of Tiered Diagnosis And Treatment System In A District Foshan City

With the improvement of people’s living standard,whether urban or rural,people’s demand for medical and health services is increasing,and their demand for the quality of medical services is also increasing.However,current medical and health resources is far from being able to meet the demand.The implementation of local medical reform policies failed to achieve the expected goal.Since the launch of a new round of medical reform in 2009,the Governments and policy-makers realize that the main reasons for the failure to achieve the expected goals are the lack of clear classification of medical services and the disorderly flow of patients.Even though the government have been introducing relevant policies and regulations in the recent decade,implementation effects in the reform practices vary due to regional culture and value orientation difference,inadequate implementation of policies and procedures,and uneven distribution of medical resources.Based on the above background,this article takes N district as the research object,trying to reveal the factors that influence the government,hospitals,primary medical institutions,and patients in the implementation of the district’s tiered diagnosis and treatment system.According to the data released by the National Health Commission,the service volume of grass-roots medical institutions has not increased but decreased in recent years,and the effect of tiered diagnosis and treatment is not obvious.As an economically developed city in Guangdong Province,Foshan still has the problem of“difficult and expensive medical treatment”,and the effect of tiered diagnosis and treatment is not ideal.This thesis selects an economically developed area,N District,under the jurisdiction of Foshan in the Pearl River Delta as the research object.The reason is that Foshan’s economic strength is in the forefront of Guangdong Province and has a strong representation in the whole province.How is the tiered diagnosis and treatment system in such an economy district? What are the problems in the value direction implemented in the tiered diagnosis and treatment system,the organizational structure established by the system,the allocation of medical and health resources,relevant technical support and supporting systems? Based on public goods theory,government failure theory and collaborative governance theory,especially collaborative governance theory,this thesis constructs a theoretical analysis framework from the dimensions of value,organization,system,technology and resources,and tried to answer the questions by issuing questionnaires to patients and their family members,medical staff and conducting semi-structured interviews with relevant government officials who responsible for the construction of the tiered treatment and diagnosis system.The analysis results of this thesis show that there are some problems in the tiered diagnosis and treatment system in N District of Foshan,such as high-level medical institutions merging the business of grass-roots medical institutions,low two-way referral rate,patients’ lack of understanding of tiered diagnosis and treatment,low participation,and high general recognition of large hospitals.Based on data analysis,regarding the above five dimensions,the analysis result also reveals the reasons for the problems in the construction of tiered diagnosis and treatment system: the organizational structure of the government needs to be improved,the positioning and division of labor of medical institutions at all levels is not clear,the implementation of supporting systems is not thorough,and the publicity of medical.