The Study On The Models And Effectiveness Evaluation Of Hierarchical Medical System In Fujian

Objective: In the current medical environment, establishing and improving the hierarchical medical system is not only contribute to improve the utilization efficiency of health resources,but also conducive to overcome the difficulties and the high expense in medical care,which puzzles the population.This is of prime importance to formate a new pattern,which cure ailments in communities, we cure serious illnesses in hospitals.This study,which bases on building health services suitable for the hierarchical medical system in Fujian Province,assesses the models of hierarchical medical and its implementation effect.On this basis,putting forward the corresponding recommendations to better promote the hierarchical medical system in Fujian Province.Methods: This study bases the data from 2010-2014 in Fujian Health Statistical Yearbook,using the method of quantitative analysis and qualitative analysis,utilizing the method of document analysis to understand the proceeding situation of grading treatment in Chinese pilot area,comprehending the main practice of hierarchical medical in Fujian Province`s pilot area,etc.Using descriptive statistical methods to calculate and analyze the impact on the health service with current hierarchical medical system.Using descriptive statistical method to calculate and analyze the impact on health services which is bring by the current grading medical system. Applying chi-square test and binary logistic regression to analyze different groups` cognition and recognition of hierarchical medical.Result:(1)Domestic hierarchical medical practical forms can be divided into four models:community family physician model which is based on the two-way referral;county and town integration service which is dominated by county-level hospitals;medical alliance which is connected at all levels of medical institutions;classified medical care which is aimed at the special diseases and the key populations.(2)According to the training of health personnel, medical service system, medical security system, the basic drug system and so on,dividing the Fujian Province`s practical form into three periods:prototype stage,rapid development stage and steady development stage.(3)According to the analyzing of the main practice of hierarchical medical,the impact on health services which is brought by the current grading medical system,and different groups` cognition and recognition of hierarchical medical,results were obtained:first,the system of the first treatment in the community,two-way referral system, basic medical insurance system and grading system for basic drugs and so on,which are existing problems;second,the advantages and disadvantages of hierarchical medical models in Fuzhou,Xiamen,Sanming and Ningde;third,different groups` cognition and recognition of hierarchical medical needs to be further enhanced.Conclusion:In order to promote the construction of the hierarchical medical system in Fujian Province,this study puts forwards some relevant suggestions in the aspects of policy guarantee mechanism,the construction of medical institutions,the founding of medical alliance,the side of the public and information construction.