Shanghai will further develop its pilot three-tier medical service system and promote more use of general practitioners as part the city's health system reforms, a local health official said at the conference yesterday.
The three-tier medical service was important to make the public medical system more convenient and efficient in a large city with an aging population and rich medical resources, said Wu Jinglei, director of the Health and Family Planning Commission of Shanghai.
As residents flocked to major hospitals regardless of their disease severity, Shanghai was the first city in China to encourage patients to look beyond hospitals for treatment. This was being achieved by setting up a community-based system to use general practitioners, or family doctors, as the front line of health care.
In the pilot system, community health centers with general practitioners are responsible for first diagnosis and referrals, as well as handling common and frequent occurring diseases, while the secondary and tertiary hospitals with specialists treat difficult and rare cases, including patients transferred from community centers.
The community-based service "becomes more and more important as they provide the most basic services, such as managing immunization for children and chronic diseases, establishing electronic health records, monitoring health indicators and providing treatment guidelines," said Wu.
"So it's important for us to bolster the capacity of general practitioners in communities to fortify the foundation of the tiered diagnosis and treatment system."
To make the referral system based on general practitioners more efficient, Shanghai has ascertained functions of different hospitals by integrating diagnosis and treatment information of all patients discharged from major hospitals in the city.
Shanghai has also established several diagnosis centers for community health centers to submit data, such as X-ray scanning images and electrocardiograms, and inviting experts to provide standardized further diagnosis services and help patients to find the doctors and hospitals best suited for them.
It has also set up a health database for all local residents for community health centers and hospitals to share patients' information. Prescriptions are extended so that patients of chronic disease can get prescriptions at community clinics after they are discharged from major hospitals.
