In this year's government work report, "family doctor contracting service" is included for the first time. This means that residents do not have to queue up at major hospitals, but can enjoy some of the medical services conveniently in the community or at home. At present, 26 provinces, autonomous regions and municipalities have issued guiding documents or implementation programs to promote family doctor contracting services.
Reporters recently found that in some of the first to enjoy the services of family doctors in the region, many people reflect the "convenient, affordable" "big hospitals run less", some areas can even "customized Some areas can even "customize" health services. According to the deployment, more than 60% of the key population will have their own family doctors this year. The contracted family doctor is becoming an indispensable part of China's hierarchical medical system.
Local "grounded" policies are coming out one after another
At the national family doctor contracting service site promotion meeting, the family doctor contracting service is listed as one of the deepening health care reform 10 key tasks this year, and will be expanded to more than 85% of the country's municipalities. More than 60 percent of the elderly population, chronic disease patients and other key groups will have their own family doctors.
China's family doctors, at this stage, are a kind of grassroots-specific service program, in which a team of family doctors forms a long-term and stable medical service relationship with the residents, who can get diagnosis and treatment services for common and frequent diseases and health management services in the vicinity of their homes by signing a contract. The basic medical services provided by the family doctor team cover Chinese and western medicine diagnosis and treatment of common diseases and multi-morbidities, rational use of medication, guidance on medical pathways and referral appointments, etc. The family doctor team can choose a family doctor on a voluntary basis. Residents or families can voluntarily choose a family doctor team to sign a service agreement.
As of the end of 2016, in the 200 pilot cities where comprehensive reform of public hospitals has been carried out, the coverage rate of family doctor contracting services reached 22.2 percent, and the contracting rate of key populations reached 38.8 percent. Many places have also made innovations according to the actual situation, highlighting the characteristics of the family doctor service to make it more "grounded".
Letting residents have their own "health records" has become the basis of the pilot program in various places. In Kunming City, Yunnan Province, Panlong District Health Bureau reporter saw, here is the development of regional population health database and health information platform, to create a family doctor plate, is conducive to the parties to comprehensive, timely and scientific grasp of the residents' health information, health management.
Experts become "partners" and residents can enjoy high-quality services. Shanghai, Jiangxi, Shaanxi and other places are also trying to explore the expert team into the family doctor service, or guidance, or in-depth participation.
Personalized service packages can meet diverse needs. Sichuan, Qinghai, Guangdong and other places have also launched a family doctor "service package". Chengdu City, Sichuan Province, has designed 30 kinds of personalized health management service packages to pilot the implementation of personalized family doctor contracting, and residents can voluntarily purchase service packages that suit their needs.
Encouragement of new technology means that residents can communicate with their family doctors more conveniently. Jiangxi, Hunan and other places have encouraged family doctor contracted service teams to utilize "Internet+Medicine" to build a communication platform between doctors and patients through the establishment of WeChat groups, QQ groups and medical Q&A web pages. Qinghai Province also encourages family doctor service teams to utilize the mobile Internet and wearable devices to provide contracted residents with information consultation, interactive communication, patient feedback, health management and other conveniences.
Residents experience more convenient and affordable
As a new thing, how do community residents understand the service model of family doctors? Mo Honggu, a family contract doctor at Hutai Health Service Center in Chengxi District, Xining City, Qinghai Province, said that in addition to relevant reports in the media, community health service centers will also make use of large screens scattered throughout the area to scroll and distribute free publicity materials.
"We will also take advantage of the time when we go to residents' homes to set up their health records to popularize the information and policies of the family doctor contracting service. When people in the community come to the clinic, we will do health education and also talk about the content and benefits of the family doctor contracting service, etc., and gradually the residents will understand the relevant knowledge." Mo Honggu said.
Duan Qiwen, 71, a resident of Wanhong Road community in Panlong District, Kunming City, Yunnan Province, signed a service agreement with the general practitioner team in 2009. In Duan Qiwen's opinion, "convenience, affordability and smoothness" are the most important features of the family doctor service. "I can call my family doctor at any time to ask for information on consultation, medication, health insurance and other aspects. Under the guidance of my family doctor, my chronic diseases have been under good control." Duan Qiwen said.
In the Dongyaofang neighborhood of Xi'an City, Shaanxi Province, the family doctor's studio comes to the neighborhood on Tuesdays and Thursdays to serve the residents. As a patient with high blood pressure, resident Wang Qinglian finds a contracted family doctor to check and consult. "The family doctor's phone is available 24 hours a day, uncomfortable at any time you can consult", said Wang Qinglian, "I used to have to run to the big hospital, now the neighborhood on the disease, I have not been to the big hospital for two years."
At the grassroots level, there are many people who are worried about the "limited level" of family doctors and have doubts. In this regard, the Chinese Academy of Social Sciences, Institute of Population and Labor Economics, Director of the Social Security Research Office Chen Qiulin said that the family doctor on behalf of a system, the team, only for the signing of the object to solve the problem well, to provide quality services, so that the residents of the actual benefit, in order to establish a relationship of trust.
Future family doctor services are more diversified
On the future of family doctor services, Wang Hufeng, director of the Center for Health Care Reform at Renmin University of China, said that in the future, family doctors will have to provide services based on demand, and the needs of the residents will be very diverse, and will need to be addressed in different categories.
"Some of the residents are key populations, the elderly, children, pregnant women; there are those in recovery and those with recent illnesses; there are family wards and end-of-life care, and the needs are multi-level and diverse," Wang Hufeng said.
He said that in the future, when more than a billion people are signing up for comprehensive services, it will be impossible to have so many doctors to do the work, which requires categorization and grading. "There are some work done by general practitioners, some may be general nurses, there may be health managers, there will be some and volunteers, social workers **** with the work. This requires integrating resources and doing system support. In the future, it is necessary to take the concept of social governance, to a greater extent, to integrate resources to meet different needs", said Wang Hufeng.
The reporter's investigation found that the current referral mechanism from community hospitals to higher-level hospitals in some areas is not smooth, making it difficult to coordinate and help patients get specialized treatment in a timely manner.
In this regard, Wang Hufeng said that the referral problem exists to varying degrees in some areas, which requires medical institutions to truly understand and implement hierarchical medical care. "Tertiary hospitals are meant to take in difficult and serious cases and put down ordinary patients. Only in this way will tertiary hospitals have the space for reasonable development in the future, in line with the needs of society, and will develop better and better in the future. If tertiary hospitals do not make two-way referrals with the grassroots, and become an 'island' of their own, it is unsustainable, because the trend of hierarchical diagnosis and treatment is unshakeable." Wang Hufeng said.