Links

March 2018, Volume 21, No.7 Abstracts(A)

Delivery Status of Contractual Services from Family Doctors in China and Advances in the Related Studies YIN Dong1ZHANG Jia-rui1WANG Zhen1ZHAI Chun-cheng1SHI Yu1XIE Feng-zhe1WANG Jing-hui1ZHANG Shu-e2SUN Tao1*

1.School of Health ManagementHarbin Medical UniversityHarbin 150086China

2.Department of PharmacyHarbin Medical University Cancer HospitalHarbin 150040China

*Corresponding authorSUN TaoAssociate professorMaster supervisorE-mailhydsuntao@126.com

   【Abstract】 In order to further activate the basic role of contractual services from family doctorsCSFD in improving the service capabilities of grassroots medical institutionsand provide a reference for the delivery of CSFD and formulation and enaction of related policieswe analyzed the current status of delivery CSFD in China and advances in the related studies mainly from 5 aspectsallocation of health resourcesoptimization of the contractual servicesexploration of family doctor team performance evaluation mechanismchanges in mode of paying contractual services by medical insuranceand residents' intention of signing a contact with a family doctor as well as their satisfaction with CSFD),and concluded that although the delivery of CSFD has achieved some fruitful resultsrelatively insufficient medical professionalsunsatisfactory service qualityunsound performance evaluation mechanism and low residents' recognition of CSFD hinder the further development of CSFD deliveryand based on thiswe proposed some suggestionssuch as giving priority to the training of primary care providersperfecting the incentive mechanism for delivering high-quality contractual servicesimproving the regional coordination in delivering medical servicesand optimizing the contractual services.

   【Key words】 Family doctor contractual servicesPresent situationResearch progress

 

Hierarchical Medical System Implementation Status in Taiwan against the Background of Universal Health Insurance Coverage and Its Enlightenment to the Mainland of China ZHANG JieTAO Si-hai*

School of ManagementNorth China University of Science and TechnologyTangshan 063210China

*Corresponding authorTAO Si-haiAssociate professorMaster supervisorE-mailjadetsh@126.com

   【Abstract】 The implementation of hierarchical medical system can hardly achieve good effects without a sound healthcare delivery system. We introduced the healthcare delivery system and implementation status of hierarchical medical system during the operation of the universal health insurance system in Taiwansummarized Taiwan's good experienceand concluded that hierarchical medical system is well under way in Taiwanthanks to reasonable cooperation mechanism between medical institutions and the implementation of network-based healthcare plan. Moreoverbased on thiswe proposed the following suggestions for promoting the development of hierarchical medical system in the mainland of Chinaimproving the service capacities of grassroots medical institutionsfacilitating the development of medical consortiumadvancing the establishment of network-based medical information sharing platformand enhancing people's awareness of healthcare as well as hierarchical medical system.

   【Key words】 Hierarchical medical servicesHealth servicesNational health insuranceTaiwan

 

Role Analysis of General Practice Department of a General Grade A Tertiary Hospital in Bidirectional Referrals WANG Rong-yingZHANG Jin-jiaZHAO Wen-wenZHANG MinWANG Ya-yiSUN Yan-jieHE Zhen-yin*

General Practice Departmentthe Second Hospital of Hebei Medical UniversityShijiazhuang 050000China

*Corresponding authorHE Zhen-yinChief physicianProfessorE-mailhezhenyin2008@163.com

   【Abstract】 Objective To explore the role of general practice department of a general grade A tertiary hospital in bidirectional referrals. Methods Through the electronic medical record system of the Information CenterThe Second Hospital of Hebei Medical Universitywe collected the medical record data of outpatients and inpatients managed by General Practice Department from 2014 to 2016and conducted an analysis focusing on these outpatients' destinationand inpatients' source and destination. Results From 2014 to 2016the annual number of outpatient visits were 12 87125 71431 583respectivelytotaling 70 168. In 2016the proportion of outpatients transferred to the general ward was 3.63%1 145/31 583),which was lower compared to 2014 and 2015P<0.017);the proportion of outpatients transferred to specialized outpatient clinics and specialized wards was 6.80%2 145/31 583 and 7.07%2 234/31 583),both were higher compared with 2014 and 2015P<0.017. During 20142016the number of annual inpatient visits were 1 8582 1892 338respectivelytotaling 6 385 visits. In 2016the proportion of inpatients transferred from the grassroots medical institutionsand from specialized outpatient clinics and wards was 81.01%1 894/2 338 and 51.03%1 193/2 338),both were higher compared with 2014 and 2015P<0.017);the proportion of inpatients transferred to the specialized wards and to the grassroots medical institutions was 22.97%537/2 338 and 36.01%842/2 338),both were higher compared with 2014 and 2015P<0.017. Conclusion The general practice department of the general grade A tertiary hospital closely cooperates with intra-hospital specialized outpatient clinics and wards and grassroots medical institutionsindicating its role as a bridge and link is increasing in the cooperation and bidirectional referrals between medical treatment units at all levels.

   【Key words】 General practice departmentHospitalsgeneralBidirectional referral

 

Experience and Associated Factors of Consultation among Primary Care Outpatients from the Grade A Tertiary General Hospital SUN Jun-jieLI Shuang-qing*

Department of General PracticeWest China HospitalSichuan UniversityChengdu 610041China

*Corresponding authorLI Shuang-qingChief physicianProfessorMaster supervisorE-mailhxjklsq@qq.com

   【Abstract】 Objective To investigate the consultation experience and associated factors among primary care outpatients from a grade A tertiary general hospital. Methods In March 2017from General Practice DepartmentWest China HospitalSichuan Universitywe recruited 200 outpatients and surveyed them by self-developed Consultation Experience of Primary Care Outpatients Questionnairefor collecting their sociodemographic characteristicsand status and thoughts about the consultation. Totaled 185 returned responsive questionnairesachieving a response rate of 92.5%. Results Of the 185 patients3116.8% obtained the initial consultation from the nearest township hospital/community hospital10556.8% acquired initial consultation from the general practice departmentand 11260.5% had never heard of general practitionersGPs. The overall level of satisfaction with the consultation among them was 87.6%162/185. Specifically13673.5% thought that the doctor had spent sufficient time on communicating with them15382.7% considered that the doctor had inquired their conditions in detailand 16790.3% considered that the doctor had explained the illness conditions clearly. Multivariate Logistic regression analysis showed that consultation lengthdetail level of the doctor's inquiryclarity level of doctor's explanation of the illness conditions were associated factors for the level of satisfaction with consultation among the primary care outpatientsP<0.05. Conclusion Primary outpatient care delivered by this grade A tertiary general hospital achieved high level of patient satisfaction. GPs often or always spend sufficient time on communicating with patientsinquiring their conditions detailedlyand explain the illness conditions wellcan improve the level of patient satisfaction with consultation.

   【Key words】 General practice departmentOutpatientsMedical experienceRoot cause analysis

 

Experience and Influencing Factors of Consultation among Primary Care Outpatients versus Specialty Care Outpatients from the Grade A Tertiary General Hospital SUN Jun-jieLI Shuang-qing*

Department of General PracticeWest China HospitalSichuan UniversityChengdu 610041China

*Corresponding authorLI Shuang-qingChief physicianProfessorMaster supervisorE-mailhxjklsq@qq.com

   【Abstract】 Objective  To study the consultation experience and influencing factors of primary care outpatients versus specialty care outpatients from a grade A tertiary general hospitaland based on thisto investigate the role of general practice department of grade A tertiary hospital in the implementation of hierarchical medical system. Methods In March 2017200 outpatients from the General Practice DepartmentWest China Hospital


Attachment

【Font:Minify Magnify】【Collection】 【Print】【Close

Related Articles

Copyright 2012 |  Journal of Family Medicine and Community Health | mail:zgqkyx@126.com | 京ICP备05034767号-1