By Xing Beilin
Since the beginning of this year, Jing'an District has actively promoted such key tasks as the community health service comprehensive reform, medical clusters construction of and the trials for tiered medical services. Jing'an District has focused on building a new model of standardized services, meticulous management and normalized application. Through medical service improvement and the provision of service items closely related to the public's needs, medical service institutions at all levels in Jing'an District have made the patients and community residents practically enjoy the convenience and benefits of medical treatment in order to find a solution for the difficulties and the troubles in seeing a doctor.
Full Coverage of Community Health Service Comprehensive Reform
With 14 community health service centers across the district to promote the full coverage of community health service comprehensive reform, the platform functions of all community health service centers continued to enhance, and the convenience and community residents’ sense of gain towards medical treatment have been significantly improved. At the 12th Chinese Community Health Service Development Forum recently held, Linfen Road Sub-district Community Health Service Center, West Nanjing Road Sub-district Community Health Service Center and Pengpu Xincun Sub-district Community Health Service Center are all on the list of "Top 100 Community Health Service Centers in 2017" .
The reporter learned from the Jing'an District Health and Family Planning Commission that Jing'an District is continuously improving the community health service network by accelerating the construction of community health service centers in the central and northern areas as well as adjusting and increasing the number of community health service stations. According to the layout planning of community health station construction in Jing'an District, 10 community health service stations will be added throughout the district by 2020, basically reaching the quota of one community health service station for 10 to 15 thousand persons. In addition, the "medical plus internet" thinking has also been applied to carry out the integration construction of a series of "Jing'an Health" information benefiting applications, including four major systems of Jing'an Health Portal, WeChat Platform, Alipay Service Window and Jing’an Health APP. The residents within Jing’an District could have access to online appointment registration, scan code payment, report inquiries, treatment records inquiries, health records inquiries, health management and other intelligent healthcare services.
While improving the hardware, each community health service center has also set their wits to explore new ways of serving the community and new paths of community and residence “combined medical and care services” to provide one-stop care and nursing services for the elderly in the community, including community medical nursing and living care. The 14 community health service centers throughout the district have respectively signed cooperation agreements with pension institutions, care providers and pension service organizations in the region. Family doctors would regularly visit various institutions to conduct health assessments, establish family sick-beds for the elderly in need, and provide personalized health management and other services.
More Than 220,000 Residents Have Signed “1+1+1”Contract Service.
As the core of the comprehensive community health service reform, the "1 + 1 + 1" mode of signing service contract with combining medical institutions based on the family doctor system is being accepted by more and more residents. Up to now, a total of 226,476 people in the whole district have concluded the "1 + 1 + 1" contract, with a signing rate of 22.65%. Among them, 160,162 people over the age of 60 in the district have signed the contract, with a signing rate of 68.78%. 66.12% of the contracted residents receive treatment in the "1 + 1 + 1" contracted medical institutions, and 63.29% of them see doctors in the community health service centers.
Through the implementation of meeting the secondary and tertiary medical institutions specialist priority, smoothing green channel of two-way referral system, extended prescription, introducing “long-term prescription for chronic diseases" and other measures, the community health service centers throughout the district have also met the basic sanitation needs of the contracting residents who suffer from the chronic and common diseases and enhanced residents' identity towards contracted services. The key contracted patients will be gradually expanded from elderly people and people with chronic diseases to pregnant and maternal women, children, people with disabilities, the loss of only child family and the elderly residents in pension institutions, etc. With the "extended prescription", contracted residents do not have to go to the secondary and tertiary hospitals to register and fill prescriptions. Those prescriptions in the secondary and tertiary hospitals have been extended and made available in the community health service centers. The patients can also enjoy free home delivery service. At present, the community health service centers throughout the district have issued 17,140 "extended prescriptions", with an amount of CNY 3.2318 million.
In addition, Jing'an District Health and Family Planning Commission has further strengthened the support of public hospitals to the community health service centers, improved the construction of functional centers such as regional imaging diagnosis, ECG diagnostic centers, and disinfection supply centers et al. and steadily promoted the homogeneity of community diagnosis. Contracted residents can have the access to the specialist consultation services of the secondary and tertiary hospitals just in the nearby community health service institutions.
"Medical Clusters" Boosts the Medical Services Level to a New High
As early as 2003, the former health department of Zhabei District began the exploration of the regional medical clusters construction ("Medical Clusters" for short). Since 2010, the former Jing'an District launched the construction of "Medical Clusters" in an all-round way. In the respects of integrating the district’s medical resources, providing high-quality, convenient and continuous basic medical and health services and promoting medical service level throughout the district, it has made substantial achievements. New "Medical Clusters" development mode of organic integration has been initially formed.
In recent years, "Medical Clusters" construction continued to be strengthened, such as the Huashan Hospital Affiliated to Fudan University - Jing'an District Central Hospital and Shanghai Tenth People’s Hospital – Shibei Hospital Medical Clusters, Children’s Hospital of Shanghai - Jing'an District Pediatric Medical Clusters, Huadong Hospital Affiliated to Fudan University - Jing'an District Rehabilitation Medical Clusters, Shanghai Municipal Hospital of Traditional Chinese Medicine - Jing'an District Traditional Chinese Medicine Hospital Medical Clusters, Shanghai First Maternity and Infant Hospital - Jing'an District Maternity and Infant Medical Clusters, etc. The medical community in the northern part of Jing'an District, led by Shibei Hospital, was officially launched this year, further enriching and strengthening the cooperation model of "multi-level collaboration, professional matching, technical support and two-way referral" between secondary hospitals and community health service centers .
Relying on the various “Medical Clusters” within the district, Jing'an District Health and Family Planning Commission has, on the one hand, established a two-way referral system of resource sharing, service standardization and effective operation so that the residents could have access to the high-quality, convenient and continuous medical services nearby and that these services are no longer “extravagant hopes” for them; on the other hand, through promoting the "Medical Clusters" specialist groups regularly visiting communities, clinical teaching, teaching ward inspection, and special diseases outpatient service, the overall community health services level have been enhanced and the synergy and continuity of medical services have become possible. There are currently 44 secondary and tertiary hospital specialists regularly visiting communities to comprehensively support the community health development.
In addition, the construction of "Medical Clusters" also helped to continuously improve the level of medical services in the three medical centers in southern, central and northern areas (Jing'an District Central Hospital, Zhabei Central Hospital of Jing'an District and Shibei Hospital). Jing'an District Central Hospital successfully passed the evaluation conducted by Affiliated Jing'an District Central Hospital of Fudan University. The three regional medical centers successfully created several national key disciplines and key disciplines in Shanghai. Discipline construction and talent work have achieved leapfrog development. The level of science, education and research has been continuously enhanced. The infrastructures have achieved continual improvement. The medical business has steadily increased. The development dilemma of “being stuck in the middle” facing the Grade II Level A hospitals in central urban area is broken initially. A tiered medical services collaboration system with Jing’an characteristics under the support of high-quality resources of the "Medical Clusters" within the tertiary hospitals and the radiation around the community health service centers have been built.