Shanghai new medical care system to explore the "medical local administrator" pilot

Because of the "medical care", "to see a doctor expensive", and be expected to health-care reform, has been closely watched. The beginning of the health care reform unfolds, let people see a clear roadmap. Shanghai, one of the medical career in our country developed areas, government departments, districts and counties, medical institutions, took his pilot's footsteps, has carefully in palate, bit by bit "crack", the benefit of citizens. This newspaper from today, launched a set series, to Shanghai is part of the pilot as a comb.

These pilot revolves around the optimize allocation of medical resources, let people like trust level 3 hospital trust community hospital, let the public hospital to shoulder more social responsibilities, let the sunshine in the grey area between medical and medicine. Attempts to do the institutional change efforts, goal is to let people enjoy a better quality, more convenient, more affordable medical services.

Break through the road, there is no precedent, is likely to be fraught with risk, difficult. But any way depends on people burst out, health care reform is no exception.

The desired effect is: in the future, tertiary hospitals are no longer overcrowded, experts can have enough time to make a diagnosis and give treatment, the research question; The secondary hospital staffer, not medical workers enthusiasm; Community doctors no longer just open a prescription for the patient, as each family health guardian.

"Medical local administrator" -- a new kind of hospital management mode, has been under way in the Shanghai pilot. This model tries to break the current independent one, two, tertiary hospitals in the city, the function of unknown situation, according to the area to the hospital to "packaging", the integration of public medical resources, to win people's trust in the hierarchical diagnostic system, at a higher efficiency for citizens to provide medical services.

Start the pilot, chongming, Shanghai luwan have conditions

Xu jianguang said recently, on the outskirts of for and luwan district of the city centre, have relatively mature conditions, is expected to start in the near future. But he also says, the pilot will encounter some difficulties, to fumble, while advancing.

So-called medical local administrator, is between the grassroots medical institutions and the public hospitals, establish closer "vertical linkage", form the regional medical association. Residents in the joint in the body, the municipal hospitals is the overall disease management program designers and executives, first and second class hospital is responsible for the technical specification of talent training, diagnosis and treatment and disease treatment process formulation, etc.; Tertiary hospital in the joint with management responsibilities.

In other words, one, two, tertiary hospitals in the same area will no longer be the difference between the nominal level, and will become a "supervisor," tertiary hospitals of basic-level hospitals steer right has the right of management, training, business, at the same time to undertake the corresponding obligations and responsibilities. This breakthrough measures, in order to let the area of basic clinical standardization and homogenization.

Improve the quality, let the residents' trust in community health care

Luwan district tertiary hospitals in ruijin hospital, secondary hospital luwan district central hospital and four community health service centers, has initially formed the framework. In recent year, luwan district community health service center has successively set up ZhuanBing management, such as diabetes, hypertension, cerebral infarction by ruijin hospital and luwan district central hospital sent the subtropical high titles more than a specialist high qualification, under the guidance to the community.

For patients, the most fundamental change is to be able to safely in the community. , the 69 - year - old Wang Apo and living in huaihai community service center in jinan community health service station next door, where she is just a prescription, intravenous drop but in the past, never a doctor. Until October of last year, she found the door also have the ruijin hospital experts, to come forward to seek treatment. "Before the level of community doctors is not assured. If the doctor can guarantee level, of course I willing to in the next door to the nearest doctor."

It is understood that the doctor is hierarchical management system. Ruijin hospital special community office, the executive director of zhao repin, ruijin hospital, neurology, rehabilitation, endocrinologist experts, has been "sent down" to the secondary hospital served as head of the department, to preach, to help, the level of diagnosis and treatment of secondary hospital of specialized subject advancement. Meanwhile, ruijin hospital and district central hospital of specialized subject doctor, monthly "down" to the huai hai, five space community - huai hai community service center of community health service stations of jinan general practitioner JiHui said: "this collaboration gives us a grassroots doctors precious improve the opportunity to learn."

According to a recent survey, in 92.1% of patients in luwan district that within the new mode, see a doctor to become more convenient, on general and specialized subject doctor satisfaction more than 97%, almost all of the patients are willing to in the community for further diagnosis and treatment and follow-up, nearly 90% of patients want to have a wider variety of chronic disease can be treated in such a manner.

Core breakthrough, guarantee the benign interaction at all levels of hospital

Another for pilot for, since last year grope for regional medical resources integration. And for counterpart cooperation with the municipal hospital, xinhua hospital affiliated to Shanghai jiaotong university school of medicine. Dean wei-guo xu said: "at the municipal level hospital and grassroots hospital cooperation, actually has conducted more than 40 years, xinhua hospital have been counterpart support for, just in the excessive marketization of medical system in recent years, weakened the counterpart in the mutual trust."

Wei-guo xu said, it is in the past 10 years, patients become "resources" of hospitals at all levels to chase, so although the competent department of health has been to promote two-way referral between hospitals at all levels, but can really "turn up" is one of the few. The reason is very simple, one, two, tertiary hospital points belong to two "husband's family" by the municipal financial allocations - tertiary hospital, is the city tube; First and second class hospital by regional financial appropriation, and district management. It is difficult to effective linkage.

Municipal health bureau said xu jianguang, director, "new" medical local administrator "mode, is likely to be from the core asset management breakthrough."

For surgeon general Peng Guifang has just completed detailed investigation, she said: "if the pilot is successful, this method is likely to be in Shanghai and even the national health care reform a very dramatic innovation."

Jian-guang xu said: "in theory, the breakthrough is feasible." Because both district-level finance and municipal finance, belong to the state funding, is the ideal way, municipal grants and district-level funding into a "big plate", thoroughly straighten out the relationship between public hospitals of different levels.

Ruijin hospital in recently provided to the municipal people's report suggested that regional medical resources integration is the key to the next step, may be in the integration of assets, this will help in medical institutions at all levels to build closer ties between contact. They put forward: "the pilot area of medical consortium can to become an independent legal person?"

The difficulties in research, it remains to be safe

2003 years later, the medical institutions at all levels of assets integration has always been a people want to dare not touch. Ruijin hospital zhao repin said: "this round of reform and the excessive marketization of public opinion is a few years ago under the proposed integration of assets, focused on the restructuring of the state-owned assets and effectively use." But asset integration breakthrough is always the hardest. Peng Guifang said: "exactly what to do, we are also a bit concern. For example, community medical institutions now after a large number of public health of the work to do? After what management? Now there is no clear statement."