Investigation And Analysis Of The Effect Of Medical Resource Integration In Jinshan District Of Shanghai

The purpose of this study is to conduct an overall evaluation and quantitative analysis of the integration of medical resources in Jinshan District of Shanghai,to summarize the current situation of medical resource integration in the region,and to analyze the constraints affecting the integration of medical resources in the region,to provide an effective practical reference for policy makers and management practitioners.Based on the "structure-process-result" theory,this study attempts to construct an evaluation index system for the effect of medical resources integration through Delphi expert consultation method,and conducts an overall and quantitative evaluation of the current situation of medical resources integration in Jinshan District of Shanghai by the evaluation index system.Based on the analysis results,interviews were conducted at all levels of the stakeholder group to analyze the constraints affecting the integration of medical resources.A comprehensive and quantitative analysis of the medical resource integration in Jinshan District and interviews with stakeholders revealed that:(1)The medical service capacity of primary medical institutions in Jinshan District has been improved to a certain extent through bed integration,personnel integration,equipment integration,information integration and capacity integration among medical institutions.The proportion of outpatient and emergency patients in the primary medical institutions has increased significantly,the number of experts from superior hospital to the primary medical institutions has been increasing,and the number of patients transferring between hospitals and the primary medical institutions has steadily increased.However,the proportion of residents with two-week illness preferring primary medical institutions decreased significantly,from 77.90% in 2012 to 71.2% in2017.The workload per capita of experts from hospitals to primary medical institutions is declining.(2)The integration of medical resources only plays a role in optimizing the stock of resources,and can not increase the total amount of high-quality medical resources.For the areas lacking high-quality medical resources,medical pressure and contradictions can only be alleviated by increasing the workload of high-quality medical resources.(3)There is a significant difference in the satisfaction of medical staff to the integration of medical resources between hospitals and the primary medical institutions,but the gap between the two is gradually narrowing.(4)The integration of medical resources in Jinshan District is a loose integration based on technical output under the administrative mandatory order.Lack of benefit-sharing mechanism between the parties involved in the integration of medical resources,and lack of needs and motivation of integration.According to the problems found in the study,the following three suggestions are put forward:(1)Breaking the interest subsidence and establishing a true community of interests is an effective measure to implement the integration of medical resources.The integration of medical resources should be promoted in the direction of “integration of human resources,finance and materials management”,and breakthroughs should be made in the aspects of mechanism and system as far as possible.(2)To clarify the orientation of regional medical centers and primary medical institutions,to form a gradient,differentiated medical service system is the goal of medical resources integration.(3)Only with the participation of financial department,personnel department,medical insurance department and other departments,and the formulation of relevant supporting measures,can we motivate the potential power for integration from medical institutions and medical staff,and successfully integrate medical resources.