Study On Optimization Of Family Doctor Services System In Shanghai

With the rapid development of economy and society and the continuous improvement of life standards,people’s demands of medical and health services is increasing.In China,medical and health services are still facing big challenges in spite of many years of developments and system constructions.Difficulties in medical service and high expenditure in medical treatment are still prominent.Community health service is an important part of the policy since the implementation of the new health care reform of China.Community health institutions ought to take the responsibility of "gatekeeper" of residents’ health.Family medical service is generally regarded as the best service mode of primary health care in the world in the process of seeking suitable community health service mode to provide high quality health service for residents.Shanghai,as an economically developed city in China,has actively explored the reform of community health services.Since 2011,it has officially begun to practice the family medical service system and put forward the overall goal that "family doctor system framework" will be established basically by 2020.Baoshan district,as one of the first pilot districts of family medical service system in Shanghai,collected much valuable data and accumulated practical experience after years of exploration and practice in all 17 community health service centers which covered all the resident in the district.Compared to the developed countries such as Britain,the United States and Singapore,the length of the family doctor service system performed in China is relatively short,and it is still in the initial stage and lack of huge practical support because it is a complex and wide-ranging livelihood project.Researches on family medical service system are short of systematical and thorough analysis in various parts of China.Therefore,this research has taken Baoshan as an example to find out the problems of the family doctor service system in Shanghai from the perspective of supply and demand,and put forward the optimization strategy of the family doctor service system.Descriptive and exploratory methods,through questionnaires,field interviews,data analysis,and literature review are involved in this research.A survey on the current situation of the supply and demand of family medical services in Baoshan District was conducted in this research.A detailed analysis of the supply and demand match state of family medical services was performed in six aspects: the number of family doctors,the content of family medical services,the typ of family medical services,the effective utilization of family medical services,the recognition of family medical services and the satisfaction of family medical services.The results indicated four problems: the number of family doctors is insufficient which leads to hard to provide high-quality family medical services to the whole population;the complementary advantages between hospitals and communities have not been formed so that family doctors are in a dilemma to provide services for residents owing to lack of resources,which affects the service results;the welfare policies such as preferential prices and medicines supply that residents expect are insufficient in family medical services;there is a gap between family medical service and residents’ expectations,the rate of medical service utilization remains low because of inadequate publicity,misunderstanding and incomprehension of family medical services.An optimized strategy of family doctor service system is proposed in this study based on the analysis of the problems.1.Design precise services according to the needs of different groups,including sick,key and healthy groups respectively.2.Strengthen the cooperation among medical institutions,promote the construction of an organized medical service through the promotion of community first consultation,two-way referral,"1+1+1" family doctor contract service and information interconnection,and ultimately reduce the burden of medical treatment for the masses;3.Improve the medical insurance system and medicine allocation system to provide more medical benefits for residents;4.Carry out appropriate and effective propaganda to strengthen the understanding of the family doctors service among medical staff and the residents for creating a harmonious doctor-patient relationship,and enhance the sense of acquisition and satisfaction of the residents.This study expects to further integrate medical and health resources,improve the service utilization of primary health care institutions,so as to construct an orderly mechanism of diagnosis and treatment service,alleviate the practical problems of difficulties in medical service and high expenditure in medical treatment,and achieve the goal of "Healthy Shanghai".