Since then, millions of residents have family doctors.

As a large city in the country, Shanghai's community health services face the challenges of deep aging, high population concentration, resource allocation and wasteful use. In June last year, Shanghai launched a new round of comprehensive reform of community health services, clearly placing community health services at the foundation and core position of the entire medical and health service system. Through mechanism adjustment and system design, we will strengthen and improve community health service networks and build communities. The function of the health service platform, the establishment of a family doctor system, thus promoting the efficient and orderly system of the entire health care system.

On March 26, the reporter went to the Longbai Community Health Service Center in Minhang District, Shanghai. The aunts who were visiting the doctors rushed to tell the reporter that the reformed community health service center was so good that they could enjoy the intimate service at their doorstep. There is a "green channel" for tertiary hospitals. You can continue to enjoy a series of conveniences when you return here. You must "like".

At the general practitioner Yang Jianling, the reporter saw the benefits of the new round of comprehensive reform of community health services that the aunts vie with. Dr. Yang is visiting the old patient Tang Jiaxuan. The old soup has undergone major cardiac surgery. Dr. Yang is his family doctor and will be followed up every month. These two days old soup felt pain in the right eye, and Dr. Yang diagnosed that he was aggravated with cataract. He suggested that he go to the tertiary hospital to see the expert clinic, and immediately booked an expert for Huashan Hospital for him. The old soup would just be registered on time to see the doctor.

It’s as simple as seeing an expert outpatient clinic that is difficult to hang on? Yes. Laotang is a beneficiary of “building a family doctor-based grading diagnosis and treatment system” in the new round of comprehensive community health service reform in Shanghai. Shanghai has started the construction of the family doctor system since 2011. At present, it has covered all the communities in the city. By the end of 2015, a total of 10.273 million permanent residents were signed, and the signing rate reached 44%. According to the questionnaire survey conducted by the Shanghai Social Research and Research Center, the satisfaction of the respondents to the attitude and service effectiveness of family doctors reached 95.5% and 89.1%, respectively.

In the new round of comprehensive reform of community health services, Shanghai issued the “Implementation Opinions on Improving the Family Doctor System in this Municipality”, clarifying that family doctors can fully mobilize health resources, build a family doctor-based grading diagnosis and treatment system, and carry out contracted residents. On the basis of the reform of medical insurance fee management, residents can choose a district-level medical institution and a municipal-level medical institution to sign a contract based on the selection of a family doctor in the community health service center to form a “1+1+1” contracted medical institution. The contract will give priority to the needs of Shanghai residents over 60 years old and chronic diseases. The Longbai Community Health Service Center near Laotangjia is one of the 19 community health service centers in Shanghai that initiated this reform. According to statistics, 77.57% of the contracted residents' clinics were treated in the “1+1+1” contracted medical institution, and 64.45% were in the community health service center. The sinking effect was obvious, and the signing residents actually felt. The benefits brought by the preferential policy of signing the contract.

For Lao Tang, what is the difference between signing a contract and the past? First of all, you can make a priority appointment in the contracted medical institution. Every time you come to Dr. Yang to see a doctor, you can make an appointment for the next visit. Secondly, you can make an appointment to refer to the upper-level hospital, the source of the upper-level hospital, and the family doctor. With the signing of patients, priority can be obtained. With the advancement of the reform, the priority will continue to increase. After the patient’s online number is not available, the family doctor can make an appointment here; again, the chronic disease signing residents can allocate one or two at a time. The monthly dose, which reduces the number of long-term prescriptions for patients traveling to and from medical institutions. The medical treatment of the upper-level hospital can still be continued. Laotang can see the expert clinic in Huashan Hospital. Dr. Yang can use the prescription drugs of the upper-level hospitals. The medicines that are not available in the community health service center can be distributed through the third-party logistics. The old soup will not be used in the short term. Going to Huashan Hospital again; in the end, you can enjoy medical insurance reimbursement concessions, Lao Tang told reporters that in the community health service center, there is no need to pay for registration, the same drug price is cheaper.

Reform has made family doctors a “gatekeeper” for residents' health, health resources and health costs. Yan Jinglei, director of the Shanghai Municipal Health and Family Planning Commission, said that Shanghai has always taken the comprehensive reform of community health services as the basis for deepening medical reform, promoting the core of the graded diagnosis and treatment system, and building a breakthrough in the rational diagnosis and treatment order. The goal of the reform is clear, that is, for the public to obtain Convenient, continuous, safe and effective health services have enabled the general public to have more sense of medical reform.

The reporter learned that during the “Thirteenth Five-Year Plan” period, Shanghai will continue to promote comprehensive reform of community health services. By 2020, the community health service center will be built as a platform for the government to perform basic health service functions, and the relationship between family doctors and residents will be signed and implemented. Comprehensive, continuous and targeted health management; the establishment of the first-level primary and grading medical system has become the main way to meet the basic medical needs of residents.

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