Hospital-Community General Practitioner Alliance Boosts China's Healthcare Reform (Preprint)

Abstract

BACKGROUND The medical association (MA) is beneficial for adjusting and optimizing the organization of the medical resources structure, promoting a downward shift in the focus and resources of healthcare, improving the capacity of primary healthcare, achieving the mutual circulation of medical resources, promoting the efficiency of the medical service system,implementing graded medical treatment and meeting people’s health needs. OBJECTIVE To understand the relevant data in the form of questionnaires in the "Medical Education Research" unit of the General Hospital Alliance of Zhejiang University, and provide a basis for the follow-up work. METHODS In August 2019, a self-designed questionnaire was used to investigate 120 units of the General Practice Union of the First Hospital of Zhejiang University. SPSS21.0 software was used for data statistical analysis. The measurement data is expressed as an average ± standard deviation, and the count data is expressed as a percentage or absolute value. RESULTS A total of 111 valid questionnaires were recovered, including 23 general hospitals, 88 community health centers and social medical institutions. Through comparative analysis, it was found that: clinical aspects: the disease diagnosis and treatment spectrum of community health service centers and general hospitals are different; after joining the alliance, the number of diagnosis and treatment of the alliance units, the number of residents’ health records management and utilization rate, the number of contracted service residents and the contracted residents renewal The rate and the number of telemedicine service units have increased from the previous ones; the passing rate of writing medical documents in general hospitals is higher than that of community health service centers, and the proportion of unqualified medical records has decreased compared to the previous ones; The pass rate is higher than before; most medical units have two-way referral institutions; most units have patient safety awareness, but fewer patients participate in medical safety activities; the health education participation rate of community health service centers is significantly higher than comprehensive In hospitals, the content and form of health education are different between the two; the awareness rate of hand hygiene knowledge is increased compared with that before joining the alliance; the pass rate of prescriptions in the general hospital wards of general hospitals in general hospitals and community health service centers is higher than before, but community health The passing rate of prescriptions in the general practice clinics of the service center was lower than before. Teaching: After joining the alliance, the number of general outpatient clinics, wards and general practitioners have increased from the previous ones, and the number of teaching practice bases, levels and training numbers have increased from the previous ones. Scientific research: After joining the alliance, the scientific research topics undertaken by general practitioners, the work of editors, and the number and grade of published articles have all increased compared with the previous ones. CONCLUSIONS The General Hospital Alliance of the First Hospital of Zhejiang University has achieved a series of results since its formal establishment, and has improved the scientific education and research capabilities of primary hospitals. It is hoped that the alliance will become an effective way to promote "two-way referral", relying on Zhejiang University The high-quality resources of the First Affiliated Hospital gradually formed an orderly medical treatment pattern and formed a sustainable development of a medical service ecosystem.