The Construction And Development Strategy Of Regional Medical Alliance In Guizhou Province

Objective: To analyze the present situation of medical development in Guizhou province in order to put forward the necessity allocation of medical resources reasonably.The requirements,expectations and existing problems of different levels medical institutions managers and medical personnel were investigated to discuss the main obstacles and solutions in the constructions and operation of medical association and the process of two-way referral,The suggestions and development strategies were proposed,so as to lay the theoretical foundation for the sustainable development of the medical association in Guizhou province.Methods: Through literature review,to understand the current situation of regional medical alliance and analyze the current situation of medical and health services in Guizhou province.According to the principle of convenience sampling,the hospital manager and medical personnel who worked in different levels medical institutions of medical association at 9 districts in Guizhou province.They were interviewed with the semi-structured interview based on grounded theory qualitative study method.Then the interview material were analyzed with NVivo11.0 qualitative software for open coding,and then conducted an in-depth research of problems related to construction of the medical association and two-way referral within the medical association through axial coding and selective coding.Results:(1)The total amount of health resources have increased in recent years in Guizhou province,but distribution unevenly,the medical institutions and personnel concentrated mainly in Guiyang and Zunyi city.(2)After three-grade coding,733 free nodes(the initial concepts),137 tree nodes(the concept),21 categories,6 main categories and 4 core categories related to the construction and development of the medical association were revealed eventually,These nodes and categories closely linked together formed a storyline: establishment of the medical association was restricted by many factors,of which policy support was the external condition;strengthen the internal organization and management,and the interdisciplinary connections was the internal factor for the operation of the medical association,guarantee the reasonable interests demands of core hospitals was the key part.(3)624 free nodes(the initial idea),93 tree nodes(the concept)and 19 categories,4 main categories and 3 core categories were revealed of two-way referral in the medical association.And formed a storyline: the choice of patients plays decisive role during the referral process,that mainly achieved by doctors’ referral behavior;the referral connections between medical institutions,on the other hand,were an important guarantee to keep the continuity of medical services,and the accompanying policy of referral was the necessary support conditions to promote the two-way referral.Conclusion:(1)The medical resources of Guizhou province were mainly concentrated in Guiyang and Zunyi city but distributed unevenly.So the medical association may be an important measure promoting the reasonable distribution of medical resources.(2)The medical association should reinforce internal organization and management;further improve the mechanism of labor division and collaboration and profits distribution,allowed the core hospitals to participate in the secondary distribution of profits in member hospitals.(3)The construction and development of medical association should breakthroughs from discipline construction,rely on information construction,promote the training personnel in community-level medical institutions,improve the capacity of community-level medical services.(4)Develop the system and supporting measures of two-way referral within the medical association,strengthen policy advocacy,maintain close connections between medical institutions so as to clear the referral channels and safeguard patients’ safety,improve the transmission of common drugs between superior and subordinate medical institutions;provided continuous medical services to patients were the necessary conditions for two-way referral.