Adjustment of management mode: in terms of organization and leadership, the county (district) medical and health general hospital should set up an "office of integration of medical treatment and prevention" (public health center or chronic disease management center) to be responsible for the integration of medical treatment and prevention in the county (district). In terms of management methods, we should establish the idea of "paying attention to both medical care and health care" and achieve synchronous arrangement, training, service, supervision and assessment of medical care and health care.
Optimize the responsibilities of departments: medical and health institutions at all levels should standardize the setting of chronic disease clinics in accordance with the principle of streamlining and high efficiency, integrate the functions, responsibilities and personnel of public health and outpatient departments, and realize the integration of public health services and outpatient departments and personnel.
Integrated service project, establishing integrated working mechanism of medical treatment and prevention
The basic public health services, major public health services and general diagnosis and treatment services will be bundled into a family doctor contract service package, and the service team will sign a service agreement with the masses on a household basis to provide health education, physical examination, follow-up and diagnosis and treatment services simultaneously as needed. For the elderly, children, pregnant women, patients with chronic diseases and other key groups of public health services that need to provide regular follow-up services, medical services should be included in the process of regular public health services.
For people who need to provide medical services, preventive interventions should be integrated into the diagnosis and treatment process. Rural doctors in the grid health service team should give full play to the "pioneer" role of residents' health management and health education, increase the frequency of daily service, put forward personalized service items and improve service quality.