Which is the best cardiovascular hospital in Beijing? Most people will say Fuwai Hospital of Chinese Academy of Medical Sciences. How to measure its good? Zhang Shu, member of the National Committee of the Chinese People’s Political Consultative Conference and director of the Arrhythmia Diagnosis and Treatment Center of Fuwai Hospital, listed three figures: Fuwai Hospital performs more than 13,000 thoracotomy a year, ranking first in the world; more than 15,000 interventional operations, ranking first in the world; cardiac rhythm More than 8,000 abnormal surgeries are performed, ranking first in the world.
“Fuwai Hospital is indeed well-known both at home and abroad, but is this a good thing?” Zhang Shu, who is a native of Fuwai, is not too proud. “So many patients are concentrated in Fuwai Hospital. Hierarchical diagnosis and treatment is not done well!”
First diagnosis at the grassroots level, two-way referral, differentiation of acute and chronic diseases, and linkage between upper and lower levels are the basic requirements of the hierarchical diagnosis and treatment model. However, Zhang Shu said that although the establishment of the hierarchical diagnosis and treatment model in my country has achieved certain results in recent years, the first diagnosis at the grassroots level is still not possible in most parts of the country, and people are still “free” to see a doctor; Less; the upper and lower are not effectively linked.
Taking Beijing as an example, 69% of outpatients in the city’s medical institutions are local patients and 31% are out-of-town patients. “How many here really need to go to Beijing University Hospital, I’m afraid not many!”
As for the reasons, Zhang Shu believes that the first is reflected in the uneven distribution of high-quality medical resources, the large cities are too concentrated, and the grassroots are too weak , community doctors, township doctors, and village doctors cannot effectively play the role of “health gatekeepers”. The second is the management system. “Which major hospital does not pay attention to the assessment of outpatient and emergency visits, and does not emphasize the bed turnover rate? If the financial support is not enough, what should the hospital do to operate normally?” interactive.
How to effectively promote the establishment of a hierarchical diagnosis and treatment model? Zhang Shu believes that in the long run, the family doctor model in Shanghai is an inevitable trend. The country should vigorously train general practitioners and solve the problem of talents before this model can truly be implemented.
The key issue is strong grassroots. Zhang Shu believes that the more important responsibility of a large tertiary hospital like Fuwai Hospital is not to provide outpatient treatment, but to help strengthen the grassroots while doing clinical research, such as exporting technology, building collaborative centers, and cultivating high-quality talents for the grassroots. etc.
It is an important measure to speed up the construction of regional medical centers in order to make more patients stay at the grassroots level and stop going to big cities such as Beijing, Shanghai and Guangzhou.
It is reported that the National Health and Family Planning Commission has divided the country into seven regions, and started to build specialized medical centers and specialized research centers in each region. “Regional medical centers can not only intercept a large number of patients, but also strengthen technical guidance to the grassroots, which can effectively relieve the pressure on the top three hospitals in big cities.” Zhang Shu said.