In 2019, the country carried out a pilot project for the construction of a close-knit medical and health community. Dingtao District, Heze City, Shandong Province, is the only pilot county and district in Heze City. It strictly follows the work deployment of the province, city and district, adheres to people's health as the center, and innovatively proposes the " Dingtao Path" for integrated county and village management, and promotes high-quality medical and health resources to the grassroots level. Make "small hospitals" achieve "big achievements" and allow the people to spend less money when they see a doctor at their doorstep.
In this process, Dingtao District implements the "eight unified" management model to build an integrated service system for counties and villages. The comprehensive information management system of medical communities has been developed and established. From the four aspects of " medical community establishment, close cooperation, resource sharing, and medical group interaction", we insist on the government's dominance, eliminate the push of medical services to marketization, and create a vicious cycle of medical reform. Under the policy of ensuring the "eight unchanged" administrative affiliation, unit nature, establishment level, personnel establishment, functional positioning, property rights relations, financial investment, and personnel identity of various medical institutions, we have formed a "eight unchanged" policy for 16 medical communities. The personnel, business, finance, medicine and equipment, medical insurance, information, performance, etc. of the member units implement the "eight unified" management model, promoting the effective integration of six major modules such as personnel, finance, medicine, referral, medical insurance, and remote consultation, realizing the online integration of medical community business, realizing traceable, adjustable and supervisable entire diagnosis and treatment process, forming a full-chain, three-dimensional medical service system that connects the entire diagnosis and treatment process, forming a top-down linkage, information connectivity, multi-disciplinary collaboration, comprehensive diagnosis and treatment, rehabilitation nursing, and medical prevention integration, a full-chain, three-dimensional medical service system. As the leading hospital of the medical community, Dingtao District People's Hospital has established and improved the construction of "six major systems" of emergency emergency, hospital infection quality control, logistics support, operation management, examination and diagnosis, and medical treatment. Grassroots Hospital actively connects with major hospitals in provinces, cities and districts through the medical community system, realizing an integrated online service system for medical community business, forming a close medical community tiered diagnosis and treatment health service chain, improving the medical needs and satisfaction of patients and the public.
At the same time, Dingtao District has achieved "four connections" in the medical community resources by building a medical community resource sharing platform. The "four connections" are the connection between expert resources, and residents can enjoy the services of county-level medical experts in townships; medical technology is connected, and most common diseases and frequent diseases are diagnosed and treated, first- and second-level surgeries and traditional Chinese medicine services can be solved at the grassroots level; two-way referral is connected, and the superior hospital has a dedicated tracking and responsible person for the two-way referral patients; public health services are connected, and the medical community integrates public health resources such as disease control and maternal and child health care, improving the quality of grassroots public health services, and achieving a benign medical treatment pattern of "small illnesses do not leave the village, serious illnesses do not leave the county, and recovery back to the grassroots level".
At the same time, Dingtao District has formulated the types of diseases admitted and diseases transferred from hospitals at all levels, including 18 village-level diseases, 75 town and street health centers and hospitals, 124 district-level diseases and referral diseases, and implemented a tiered diagnosis and treatment system to guide patients to seek medical treatment in an orderly manner in different medical institutions according to the condition, implement a tiered diagnosis and treatment catalog system according to the disease type, optimized the program functions of referral, remote outpatient, consultation, cloud imaging, etc., so as to ensure that the referral system is implemented in an orderly manner, and the online settlement model is implemented.
In addition, Dingtao District also adopts pairing assistance to improve the level of medical services across the region. During the construction of the medical community, Dingtao District implemented fixed assistance pairs for county-level hospitals, + community health centers, town and street health centers + village health centers, established a green channel for upper and lower referrals, placed an order through a two-way referral system, and directly arranged treatment at county-level hospitals for medical treatment, and exempted registration fees; patients can implement remote outpatient clinics, consultations, and film readings with provincial, municipal and district hospitals through the medical community platform, saving patients' expenses and time to go to higher-level hospitals.Dingtao District People's Hospital has taken the "100 Doctors Going to the Grassroots" activity as a key task of the hospital for a long time, providing uninterrupted and all-round free assistance, improving the grassroots health service capabilities of the whole district. It regularly selects medical experts and senior nurses to form a team of 92 experts, and goes to various communities, town and street health centers and village clinics. Combined with the public medical institutions and public health teams in the community, town and street, and is guided by residents' health needs. According to the characteristics of the population in the region, it studies and determines medical and prevention integrated service projects, coordinates the promotion of key tasks such as health promotion, chronic disease screening, intervention and management, and goes deep into town and street health centers to provide medical and assistance, so that the people can enjoy the medical services of district-level experts at their doorstep. At present, the expert team has received a total of 15,300 people, helped the towns and streets to form 112 family doctor teams, and served 533,400 people. From January to August 2022, the county medical treatment rate was 86.5%, an increase of 4 percentage points over the same period in 2021. The cumulative referral performance of member units was realized in total 220,000 yuan. From January to August 2022, there were 970 patients transferred, 20 patients transferred, 610 patients treated, 210 consultations, 320 film reviews, 36 surgeries at the grassroots level, 46 rounds with teaching rounds, helped the grassroots level carry out 23 free medical consultations, and implemented 1 new technology and new project (Chronic obstructive pulmonary disease), so that the people can truly enjoy the benefits brought by the construction of the medical community. (Text/Li Chengling)
Author unit: Dingtao District Health and Health Bureau
Editor: Yan Xiufeng
Review: Zhang Min
