Research On The Improvement Of Medical Service Capacity Of Primary Health Institutions Under The Mode Of Medical Alliance ——Taking Zhengzhou Z Medical Alliance As An Example

ObjectiveOn July 17,2020,the National Health Commission and the National Administration of Traditional Chinese Medicine issued a notice named “Measures for the Administration of Medical Alliance”.In order to further understand the operation of medical service system in primary health institutions under hierarchical diagnosis and treatment system and the mode of medical alliance,this paper combines the "structure-process-result" theory to construct a medical service capacity evaluation model for primary health institutions under the medical alliance mode,taking the primary health institutions under Zhengzhou Z medical alliance model as the research object,to evaluate the medical service capacity of the primary health institutions,and to find out the main problems in improving the primary medical service capacity under the medical alliance system and put forward countermeasures,which will be beneficial to promote the medical service capacity of Zhengzhou primary health institutions and also able to provide reference for other regionsMethodsThis paper firstly uses the key person interview method and combines the "structure-process-result" theory to construct an evaluation model for the medical service capacity of primary health institutions under the medical alliance mode,and determines the weights of the evaluation indexes of each level of the model by using the method of analytic hierarchy process.Secondly,the Zhengzhou Z medical alliance,as the specific research object,10 primary health institutions joined the Z medical alliance at the end of2019 were selected as samples.Taking 2019-2020 as the time node,method concluded consulting the annual report and system of Zhengzhou Z medical alliance and relevant data on the spot,combining with the interview of relevant interest groups in the medical alliance;At the same time,a questionnaire survey was conducted for medical staff and patients in primary medical institutes,103 and 100 questionnaires were collected for medical staff in two years,and 304 and 300 questionnaires were collected for patients in two years.Finally,according to the constructed evaluation model,the medical service capacity of primary health institutions before and after joining the medical alliance was comprehensively evaluated and analyzed from the aspects of structural dimension,process dimension and result dimension.ResultsAccording to the evaluation and analysis of the effect of improving the medical service capacity of primary health institutions under the medical alliance mode,it is found that even the medical service capacity of the primary health institutions investigated has been improved to a certain extent,but the overall medical service capacity of the primary health institutions in the region is not high.The Z medical alliance mode has little effect on improving the medical service capacity of primary health institutions,and many problems still exists in the operation of the Z medical alliance,which keep in line with the actual situation of the construction of the loose medical alliance in Zhengzhou as the survey results.Among them,each index is scored one by one from the structural dimension.The survey results show that in terms of the allocation of medical resources in the surveyed primary health institutions,although the number of medical staff has reached the policy requirements,the structure of health human resources is unreasonable,such as low academic qualifications,lack of intermediate or senior professional titles;in terms of the interaction mechanism between the member units of the medical alliance,although the detailed rules of the medical alliance have been issued,there are problems such as unsatisfactory implementation of the system and lack of an assessment mechanism;In terms of the process dimension,each index is scored one by one.The survey results show that although the utilization rate of medical resources of the primary health institutions in the surveyed medical alliance,has been improved to a certain extent,and after the technical assistance and personnel training of the higher-level hospitals,the service ability of the primary health institutions has improved.But due to the lack of effective supervision among medical alliances and the influence of factors such as the concept of patients seeking medical treatment for the first time,there are still problems such as difficulty in referring patients to the primary level and low utilization of resources at the primary level;In terms of result dimension,the results of interviews and questionnaires show that,influenced by the loose medical alliance management model and the single and weak publicity of the hierarchical diagnosis and treatment policy,patients do not trust primary medical services,they are not willing to have medical treatment or to transfer to the primary medical institution,which result in insufficient utilization of grassroots health resources,therefore,the concept of patients’ first consultation and medical treatment needs to be changed urgently.ConclusionsTo improve the medical service capacity of primary health institutions in this region,it is necessary to continue to increase the financial support and incentive mechanism for primary health institutions,and introduce supporting measures to promote the sinking of high-quality resources;Establishing and improving the supervision mechanism of medical alliance,strengthening the construction of talent team in the primary medical institutions;At the same time,it is necessary to drive the medical staff to increase their participation in the medical alliance,play the role of gatekeeper of health,so as to gradually change the concept of patients seeking medical treatment,and make rational use of health resources,in order to achieve the purpose of promoting the physical and mental health of more people.