Apr 12, 2022
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The hierarchical diagnosis and treatment system is currently in the process of improving service capabilities and guarantee mechanisms, and various localities have implemented this system to varying degrees. So what assistance can "Internet +" do for hierarchical diagnosis and treatment? What opportunities does it have? 1. The state's top-level design for hierarchical diagnosis and treatment In 2015, the "Guiding Opinions of the General Office of the State Council on Promoting the Construction of a Hierarchical Diagnosis and Treatment System" proposed the goals and tasks of hierarchical diagnosis and treatment in my country:By 2020, the capacity of hierarchical diagnosis and treatment services will be improved in an all-round way, the guarantee mechanism will be gradually improved, and a medical service system with reasonable layout, appropriate scale, optimized job title email list levels, clear responsibilities, complete functions, and high efficiency will be basically established. The hierarchical diagnosis and treatment model of divided treatment and upper and lower linkages has been gradually formed, and a hierarchical diagnosis and treatment system in line with national conditions has been basically established. 2. Local implementation cases 1. Quanzhou's implementation of hierarchical diagnosis and treatment 1) Encourage grass-roots first diagnosis measures Starting from chronic diseases, hierarchical diagnosis and treatment: start with chronic diseases such as hypertension and diabetes, and implement the first diagnosis at the grassroots level, two-way referral, classification of acute and chronic diseases, and linkage between upper and lower levels. Encourage the contracting of family doctors: the payment of family doctors shall be paid by the establishment of the medical insurance (new rural cooperative medical system) fund, basic public service funds and individual residents, and the three parties shall share. 2) Measures to balance the medical level Encourage doctors from higher-level hospitals to practice at the grassroots level: guide doctors from higher-level hospitals to go to grassroots medical institutions to carry out family doctor contract services and multi-site practice. The income is linked to the contracted service residents. The more services contracted, the higher the income. 2. The implementation method of hierarchical diagnosis and treatment in Zhejiang1) Encourage grass-roots first diagnosis measures Except for a few specified special diseases, other diseases shall be first diagnosed at the grassroots level: except for critical patients, emergency patients, patients undergoing follow-up visits and other special circumstances, when a patient seeks medical treatment for the first time, in principle, the first consultation should be made at a local medical institution. For diseases that cannot be handled by the first-diagnosed medical institution, the patient will be referred to a higher-level medical institution according to the patient's condition. Differential payment of medical insurance and classification of medical expenses: Guide and promote by means of differential payment of medical insurance, setting prices for medical services in medical institutions of different levels, and standardizing referral procedures. For patients who participate in urban employee medical insurance, urban residents' medical insurance, and "new rural cooperative medical care", if they go to medical institutions outside the region for medical treatment without referral, the proportion of medical insurance reimbursement will be significantly reduced. 2) Criteria for two-way referral Transfer standard: After the first diagnosis, there are six criteria that can be referred to a higher-level medical institution: including cases of acute and critical illness in various clinical departments that are difficult to implement effective treatment; difficult and complex cases that cannot be diagnosed; cases with limited ability to deal with major casualties; diseases Diagnose and treat cases that exceed the approved diagnosis and treatment registration subjects; cases that need to be further examined at a higher-level medical institution to confirm the diagnosis; other cases that cannot be handled due to technical and equipment limitations. Switch back to standard: After the patient's condition is stable, the following six criteria are met, namely: the condition is stable after the acute phase treatment and needs to continue rehabilitation treatment; the diagnosis is clear and no special treatment is needed; advanced non-surgical treatment and hospice care for patients with various malignant tumors; need long-term Cases of chronic diseases treated; elderly care cases and cases of general common diseases and frequently-occurring diseases must be transferred back to lower-level medical institutions.