This county in Henan breaks the curse of the loss of patients at the grass-roots level, and township-level hospitals "suck back" patients from county hospitals.

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Why did Jiaxian County break the curse of the loss of grassroots patients? Everything should be started from the construction of medical community.

In Jia County, Henan Province, in 2020, 3289 patients in the medical community will be transferred to the township level and 613 patients at the county level. Township-level medical institutions will begin to suck away patients from county hospitals. Why did jia county break the curse of the loss of grassroots patients?

Everything should be started from the construction of the medical community.

In 2019, jia county was identified as a pilot county for the construction of a national compact county medical community. At that time, there were 404 medical and health institutions in Jiaxian County, including 7 county-level medical and health institutions, 13 township health centers, 2 community health service centers, 377 standardized village clinics, and 5 private hospitals. In order to survive, institutions at all levels have their own ranks, and layers of barriers have seriously affected the implementation of the hierarchical diagnosis and treatment system.

In order to solve this problem, Jiaxian County established a hospital management committee. The secretary of the county party committee personally went to the battle as the director, and the county magistrate served as the first deputy director to perform the government's medical duties. Under the promotion of the medical management committee and the health and health committee, it was finally led by Jiaxian People's Hospital, United County Hospital of Traditional Chinese Medicine, County Second Hospital, County Maternal and Child Health Hospital, County CDC, County CDC, 13 township health centers and 2 community health centers, jiaxian Medical and Health Group was formed. After the completion of the integration of resources, Jiaxian County began to fully optimize the medical layout. In order to control the county's transfer rate, the county level has set up 28 multidisciplinary expert teams, focusing on improving the level of emergency and critical care treatment and consultation in the county. At the same time, it has carried out joint construction of disciplines, highlighting the misplaced development and complementary advantages of traditional Chinese and western medicine, disease control and maternal and child health care. It has built 32 Junior College alliances with urban hospitals, greatly promoting the development of disciplines in county-level hospitals. At the rural level, we will strengthen the capacity building of rural medical services with common diseases, frequently-occurring diseases and chronic diseases as breakthroughs. 25 departments will be built by higher-level hospitals and township health centers to fill the gaps in otolaryngology, stomatology, ophthalmology and other departments of township health centers, and help township health centers to develop 73 new businesses and new technologies, so that the masses can enjoy the level of county-level diagnosis and treatment in township health centers.

After the service capacity of township hospitals is improved, the opportunity to implement hierarchical diagnosis and treatment is mature. Jia county officially issued a two-level diagnosis and treatment catalogue at the county and township levels, with 442 kinds at the county level and 75 kinds at the township level, thus truly realizing a reasonable diversion of patients. Facts have proved that these measures of Jiaxian medical community construction are reasonable and effective. From 2019 to 2020, the overall medical service capacity of Jiaxian County has been significantly improved. The proportion of 3. level 4 surgery in county-level hospitals reached 33.42 percent, an increase of 7.46 percentage points over the same period last year, the rate of grass-roots visits in the county 66.48, an increase of 4.61 percentage points over the same period last year, and the hospitalization rate in the county was 83.57 percent, an increase of 0.39 percentage points over the same period last year.

"Internet + Medical Health"

Grass-roots health institutions "to live" is an important basis for the realization of hierarchical diagnosis and treatment. In order to help rural areas establish a long-term development mechanism, jia county has implemented a health community digital project within the medical community, established a three-party linkage information system linking the county and village levels with medical care, medical insurance and medicine, and promoted the digitalization and integration of management such as resource allocation, business operation, quality evaluation, financial analysis and effect monitoring within the group. Based on this, six sharing centers, including medical imaging, ECG diagnosis, clinical examination, pathological examination, disinfection supply and remote consultation, will be established with "upper and lower connectivity, service homogeneity and mutual recognition of results" as the core, so as to boost the development of "internet plus Medical Health. Internet technology has also been applied to basic public health services. Jiaxian County has equipped 14 townships with 12 national basic public health service cloud inspection vehicles. In the cloud inspection vehicles, automatic biochemical analyzer, B- ultrasound, ECG machine, health all-in-one machine and other basic medical equipment are readily available, and common physical examination items such as height, weight, blood routine, ECG and so on can be realized, data such as inspection results and personal health information will be uploaded to the provincial basic public health service information platform synchronously, and the inspection results will be pushed to the mobile phone of the masses at the same time, thus realizing real-time interaction and one-click synchronization between residents' health file information and mobile APP client. It is with the help of cloud patrol vehicles and Internet technology that 91 family doctors contracted service teams have found out the health status of the grassroots people and promoted the contracted service to be effective.