Comment on: hierarchical diagnosis and ideal is very plentiful Reality is very skinny
 
 
The 2014-10-24 
 

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        Patients to choose where to see the doctor, besides made feeble constraints reimbursement ratio, basic there is no other way. If not from the aspects of software and hardware, raise the level of the small hospital medical grading diagnosis and treatment is likely to become empty talk. 
 
        Small hospitals, large hospitals are overwhelmed, this kind of phenomenon in zhejiang or will change in the future. According to media reports, begin at the end of October, zhejiang pilot will start batch of provincial classification diagnosis and treatment. Chunan county, beilun ningbo, sea and other eight into pilot county (city, area) people in the doctor to see a doctor, to the local grassroots medical institutions first option first. 
 
        Hierarchical diagnosis is a very good idea, it can reduce the burden of the pressure of big hospitals and patients. Big hospital in the registration fee is high, check equipment, and easy to run into excessive examination of misfortune, also easy to prescription, drug with a high price. As a result, once a doctor really realize hierarchical diagnosis and treatment, large hospitals are overwhelmed phenomenon will greatly improve, expensive phenomenon will also change. 
 
        However, in my opinion, at least at this stage classification diagnosis and treatment of the actual effect, remains to be seen. Because, patients are very pragmatic, not theorists, especially relates to the life safety and health problems. In oneself cannot judge the size of the illness cases, will certainly worry to the small hospital misdiagnosis or delay treatment. 
 
        And big hospitals are not just department, hospital beds, medical staff, there are two critical problems, is a small hospital especially clinic can't than. Is a large hospital has complete and advanced equipment; Second, the big hospital doctors clinical experience, medical technology, diagnosis of the patient is relatively accurate, and an expert doesn't solve problems, can the collective consultation, together to solve the problem, want to ask a small hospital experts are difficult, please many expert group consultation from? 
 
        Where there is no denying the fact that patients who choose to see a doctor, but to use health care reimbursement ratio can be used as a feeble constraints, the basic request there is no other way to patients first from the lowest level of the hospital diagnosis and treatment, the patient could not put the body when it is to treat bad to the hospital at the next higher level. Because patients in order to own life safety and health, have the right to choose the best hospital. Moreover, the difference of service attitude and service level, is also a big hospital factor to attract patients. Patients also have the right to choose its own in its trust or like hospital, with executive order intervention is not reality. 
 
        Visible, the administrative department of public health for grading diagnosis and treatment, the ideal is plump, reality is likely very skinny. Therefore, the author thinks that, no matter where the administrative department of public health, if you really want to determined to carry out classification diagnosis and treatment, there are only two results: one is to advocate, as to how reality, can only be left alone. One is to put the hospitals at all levels to create high levels of doctors, and check for all levels of hospital equipped with advanced equipment, the hospitals at all levels have the ability to bear the "grading diagnosis", otherwise, hierarchical diagnosis and treatment is likely to become empty talk. 
 
        Bing-jie li (medical workers)
 
 
 
 
The original link: http://www.jkb.com.cn/news/commentary/2014/1024/353445.html