Research On Problems And Countermeasures Of Promoting Hierarchical Diagnosis And Treatment System In Chengdu

Along with the high-speed development of social economy,the improvement in people’s quality of life and health get much attention,people increasingly demand a higher level and more high quality medical service,but lacking of medical resources in our country,and uneven distribution,great differences between regions,between urban and rural health resources,the increasingly major contradiction between supply and demand.Medical and health resources in our country mostly in the big cities,and the vast majority of high-quality medical resources concentrated in large and medium-sized hospitals,grassroots medical institutions accounted for only a small medical resources,when patients need a doctor,would flock to the medical level is high,large hospital facilities,rather than choose grassroots medical institutions,causing big hospitals are overwhelmed,"Difficult to see a doctor,expensive to see a doctor" and the tension between doctors and patients and the common phenomenon of apathy in primary medical institutions.The contradiction between supply and demand of medical resources poses a great challenge to the existing medical and health service system in China.In order to solve this contradiction,the state launched a new round of deepening the reform of the medical and health system in 2009,and issued the Opinions of the CPC Central Committee and The State Council on Deepening the Reform of the Medical and Health system,requiring medical institutions at all levels to actively promote hierarchical diagnosis and treatment.According to the indicate of the government,local governments have actively responded to the implementation of the hierarchical diagnosis and treatment system in different ways,and some localities have also achieved good experience and results.Last several years,Chengdu has actively stimulate the development of hierarchical diagnosis and treatment system.Based on the public service equalization theory,stakeholder theory and new public service theory,the paper has an in-depth understanding of the background,policy means,implementation status and achievements of the hierarchical medical system in Chengdu.In the mean time,through the questionnaire survey and communicating with relevant personnel,problems existing in the implementation of hierarchical diagnosis and treatment system in Chengdu were found and analyzed from the perspectives of patients,medical and health institutions and the government,mainly including: Patients hospitalized habits affect the choice of treatment,patients of hierarchical diagnosis and insufficient cognition and ability of grassroots medical institutions,medical institutions between conflicting interests,lack of medical information sharing platform,lack of unified standard referral,insufficient government investment in basic medical and health institutions,health care policy effect is not obvious,the grading system propaganda doesn’t get the designated position,Based on the existing problems,targeted rationalization suggestions were put forward,including guiding residents to change their medical behavior,straightening out the relationship between medical and health institutions at all levels,improving the capacity level of primary medical and health institutions,and improving the medical security system.