| Graded diagnosis and treatment is based on the priority of the disease and the difficulty of diagnosis and treatment.Different levels of medical institutions undertake the diagnosis and treatment of different diseases,so as to achieve the first diagnosis,two-way referral,rapid division and treatment,and up and down linkage,and finally form a minor illness.Reasonable medical treatment in the community,major illnesses to the hospital,and rehabilitation back to the community.80% of China's medical and health resources are concentrated in major cities,and 80% of them are concentrated in large and medium-sized hospitals.Primary medical institutions have few resources,and the overall structure of resources is “inverted triangle”.In contrast,most of the medical needs are concentrated at the grassroots level,presenting a “positive triangle” shape.The contradiction between the "inverted triangle" of medical resource supply and the "positive triangle" of medical demand has led to the difficulty of seeing a doctor and expensive medical treatment.Graded diagnosis and treatment can effectively solve this contradiction.At the same time,it can control the bad phenomena of small illnesses and major diseases,and combine policies with medicines to control medical insurance expenses.Since 2015,Dalian City has implemented a grading diagnosis and treatment system.In-depth investigation and analysis of the problems and causes of the implementation of this new public medical service model are of great significance for improving the policy system and providing effective primary medical services.Based on the relevant literature at home and abroad,based on the theoretical and policy basis,the doctors and patients of 21 community health service centers(station)in the five districts of Dalian were surveyed and the health administrative departments and medical personnel were The patient conducted an interview survey and analyzed the current status of the implementation of the graded diagnosis and treatment system in Dalian.The results of the study show that: Grassroots medical staff generally have insufficient confidence in the current and future development of personal career development,center development,graded diagnosis and treatment,and have low satisfaction with the sense of accomplishment and honor of individual occupations,and are dissatisfied with the facilities and equipment of the center,plus The insufficient number of GPs at the grassroots level directly leads to the low enthusiasm of medical staff for advancing the grading system.Patients have insufficient confidence in the center,the awareness rate of graded diagnosis and treatment is very low,traditional medical treatment habits are difficult to change,and the overall participation in the classification and treatment system is not high.Combining the experience of domestic and international grading diagnosis and treatment system,combined with the actual situation of Dalian,this paper proposes to improve the basic medical and health service capabilities,including increasing financial input,reforming the salary system,strengthening the counterparty assistance of large hospitals;strengthening the training of general practitioners,including improvement The general practitioners cultivate policies and mechanisms,implement multi-point practice policies,and leverage the price of medical insurance and medical services,including raising the proportion of first-line reimbursement at the grassroots level,changing the payment method of medical insurance,dynamically adjusting the price of medical services,and clarifying the positioning and transfer of different medical institutions.Standards for standardization;standardization of policy creation and evaluation system,including providing sound policy support and establishing a standardized evaluation system;strengthening policy propaganda,including policy recommendations to enhance the awareness of the masses,enhance the trust of the masses,and adhere to voluntary residents. |
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