Community Health Service Center In The "Hospital Managed Community Health Services" The Influence Of The Hierarchical Medical System

At present,the domestic medical resources distribution,the waste of resources and shortage of resources still exists,the doctor-patient contradiction is highlighted.In 2015,the state council improved the hierarchical medical system as one of the seven key reform tasks,To achieve "the first option in the basic level,two-way referral,slow partition,upper and lower linkage," the basic requirement of hierarchical medical system;you should clear medical units in different levels of function orientation with reasonable shunt people,the most common disease and frequently-occurring disease could be solved in primary medical institutions.This also will request basic-level medical institutions to take on the responsibility of the basic medical services and public health services,Therefore,do a good job in the management and operation of basic medical institutions is significance.In Shenzhen,hospital managed community health services extended to promote the hierarchical medical system,So the study of hospital managed community health services system under the government's policy,hospital management mode and operation form of community is the key,the management system whether it can effectively promote the hierarchical medical system is this research focuses on and try to answer.Through literature analysis,analysis interviews,participant observation and other methods,in deepening the reform of medical system in Shenzhen City,hospital managed community health services in Shenzhen is stipulated in the way of document of the government,the beginning of the trial brought the rapid spread and guarantee of community health service center the quality management and logistics,and promote community health centers and hospital resource sharing role.But with the further,hospital managed community health services appeared symptoms,Flaws in the system and the inner conflicts of interest increasingly apparent,mainly in three aspects for the hierarchical medical system is not smooth,the brain drain phenomenon is obvious,difficult to supervision,Judging from the final result,the system also restricts the basic level of medical service community health center grading clinics and basic public health service level.Therefore,the hospital managed community health services should be improved in three ways.First,breakthrough and optimization of hospital managed community health services,set at the level of community management,and ease the conflict of interests,take the difference of financial subsidies,improving the performance appraisal to fill the blank of supervision.Second,to explore the community first diagnosis grading system,thereby optimizing two-way referral,landing family doctor contract,to explore the pilot part of the population of the family doctor first consultation system,to guide residents reasonable treatment habits.Third,encourage the third party participation in community health service center,and to explore the medical support combined with extended hierarchical medical system.