Hierarchical diagnosis not force people to go to see a doctor at the local level

Renmin university of China Wang Hufeng, director of the center for health research

09:28 September 7, 2016

Source: People's Daily online - health channel

Xiamen classification of diagnosis and treatment is not perfect, but it is now one of the best in the country. Why do you say that? Xiamen classification of diagnosis and treatment has four characteristics.

The first is the voluntary crowd. From the beginning, xiamen provide residents with optional services, all the residents can go directly to 3 armour hospital sees a doctor, not forcing people at the grassroots level. But more and more people are voluntary to the grassroots to go to a doctor, because xiamen provides the high quality fine service to attract people to the community.

Second, to provide value-added services. Sink at the grassroots level through high quality resources and integrate the public health service provides many others did not, called series of value-added services. For example, large hospital is "quick three slow seven", in the basic unit for the stabilization of slow disease patients, xiamen is extended to two months. Reservation outpatient service, for example, large hospitals can only seven days in advance booking directly, in the community outpatient appointment can be ten days in advance. And health management division, fine service, meet the requirements of the chronic patients. So chronic patient is voluntary to the community, and are stuck to the community, is happy to in the community to see the doctor. This is depend on the support of large hospital, the high quality resources of sinking, rely on incentives and refinement of the services to attract patients in community voluntary to the grassroots, which cracked the classification problem of diagnosis and treatment.

Third, providing personalized service. Slow disease is in many different conditions, stability, wave period, critical condition. Late in xiamen, patients with critical condition to strengthen the management, routine management, key crowd high-risk groups according to the illness is if the patient needs still can obtain the key management. In many communities, as well as friends and "street", helping, street or patients, between patients with communication, guidance, help each other, to some extent improve the efficiency of the intervention and treatment.

Fourth, set up referral director. The patient's turn and turn on by medical personnel responsible for contact. Service line, ensure that the patient not to walk to success, this is the essence of hierarchical diagnosis and real: provides a continuous service management.

Xiamen health reform has four major effects: the first effect is common people welcome, has won the hearts and minds. This place vivid examples if we way right, management is fine enough, hierarchical diagnosis and promotes the overall satisfaction of the residents.

Second, employee satisfaction improved. Big hospital return to a mysterious illness function orientation, medical staff found the professional dignity, got the respect of the society. Of "barefoot doctors" is back in the new period, the relevant departments to adjust the incentive policy, grassroots medical staff also increases the income, so the stability of the team at the local level.

The third is a xiamen grading diagnosis and beneficial to promote health. Diabetes, high blood pressure, success rate increased significantly. Future comprehensive evaluation classification diagnosis and treatment of the influence of social economy, China need to find out the answer to this is our health.

The fourth is to promote the social harmony. Gp now became the most trusted people, hierarchical diagnosis and become the most warm the heart of the people's livelihood project.

I summarize the pattern characteristics of xiamen in 19 words: strong base, promote health, three division condominium, flexible reform and sustainable development. Xiamen on many operational details do create the experience, is worthy of reference for other places.

In the future, hope I can from xiamen longitudinal deepening the refinement of the services, gradually widen the diseases were chronic diseases, from the horizontal with the beginning of the family contract continuously improve the management of chronic illness coverage, xiamen believe the future will provide more and better experience.

(article extracts from August 30 xiamen spoke Wang Hufeng reform progress communication meeting)