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What is the international experience of the medical service delivery mode of the Academy of Social S

Issuing time:2019-12-17 00:00

1、 Specialization of medical service

In traditional medical service provision, medical service is only provided by hospitals and doctors' clinics, from medical treatment, laboratory test, diagnosis and treatment to postoperative rehabilitation and chronic disease management. The above two types of institutions almost cover all functions. Such "large and comprehensive" institutions have high operating costs, unclear main functions, and a large number of costs are put into daily operation, rather than the treatment of patients The emerging medical service mode shows the characteristics of more specialized division of labor. It disperses multiple functions to various independent institutions, and provides patients with cheaper and efficient services with the help of constantly improving information technology and diagnosis and treatment technology.

The service efficiency can be significantly improved by only dispersing diagnosis and treatment to different institutions.

With the help of information technology, patients can upload their own test results through the Internet to obtain accurate diagnosis from professional doctors, while treatment can be completed through micro clinics, specialized hospitals, etc. On the basis of accurate diagnosis, the treatment of many diseases is only a controllable and replicable process, which can be completed by doctors' assistants or even nurses.

There have been quite a number of institutions dedicated to this in the United States, such as the redI clinic and minute clinic, which were acquired by CVS, a chain drugstore in the United States in 2007, surgical specialty hospitals such as Shouldice hospital, as well as many ophthalmic clinics, heart disease hospitals, cancer rehabilitation centers, etc. Compared with traditional hospitals, which charge for all services on a project basis, these treatment focused institutions have started to charge patients a fixed fee based on a single procedure. The process is unified, the risk is controllable, and the medical expenses are clear and definite. In September 2006, the Geisinger health system's provencare program began charging insurers a fixed rate for selected bypass operations, along with a 90 day shelf life.

Clayton Christensen's research shows that these clinics, which only provide specific treatment services, are able to provide a comparable level of medical services at half the price compared with medical institutions that provide diagnosis and treatment at the same time. In the same treatment of external abdominal wall hernia, shordays hospital only treated a few types of external abdominal wall hernia patients, but all patients used the same clinical pathway, only four days in total, relying on the day before meal preparation, the next day for surgery, the third day and the fourth day for recuperation, the assembly cost is 2300 dollars, the patient satisfaction rate is close to the vast majority, and the litigation cost of medical accidents is almost zero; In contrast, in a general hospital in North America, the cost of the same operation is $3350, and the operation is completed in the outpatient department, and if the patient is hospitalized, the cost will be as high as nearly $7000.

Upper respiratory tract infection, nasosinusitis, pharyngitis and other common frequently occurring diseases can also be treated in the micro clinic mainly operated by nurses. According to Mary Kate Scott, an expert in the field of micro clinics in the United States, a total of 60 to 100 kinds of diseases can be treated by micro clinics with the right technical support. Although there are limited types, these diseases account for 17% of the diseases of visiting family doctors in the United States. The cost of treating these diseases by micro clinics is 32% to 47% lower than that of visiting family doctors. It is convenient and fast, and does not need to queue up. It also greatly reduces the time for patients to see a doctor, and greatly improves patients' satisfaction.

Because nurses are enough to play a major role in the new medical service model, which greatly reduces the work burden of doctors, doctors' human resources can be more devoted to professional clinical diagnosis.

The Cleveland Clinic in the United States changed the original center into an organization characterized by cross department expert cooperation through reorganization, such as hiring oncologists, radiologists, neurosurgeons, psychiatrists and psychologists in the Institute of Neurology, integrating with neurologists to diagnose the causes and different types of patients as accurately as possible. The continuous accuracy of diagnosis promotes a better division of labor between diagnosis and treatment.

In addition, doctors can also greatly expand the scope of providing medical diagnosis with the help of information technology.

In the traditional community, the service scope of a general practitioner is about 1000 to 1500 people. In the new medical service mode, patients no longer need to rely on face-to-face medical service mode. Doctors can provide services and make diagnosis to patients from all over the world with the help of the Internet. In this new service mode, the general practitioner team can expand its service scope to 5-10 times of the original traditional mode.

New Mexico State University's echo project uses electronic communication technology to provide specialized medical services, such as hepatitis C and AIDS treatment, to rural communities in New Mexico. However, the echo project is completed through the cooperation of specialists and local medical service providers. In this process, the technical ability of local medical staff has been improved, indirectly promoting the improvement of local medical service level. This is obviously of great significance to developing countries or underdeveloped regions.

2、 Establish coordination network to promote self-healing of patients

The rapid development of the Internet in every corner of life also brings new possibilities to the treatment and management of chronic diseases.

The therapeutic effect of many chronic diseases is closely related to patients' own life style and daily behavior. How to improve the compliance of patients with chronic diseases to the treatment plan is a headache for many doctors. Only relying on doctors' prescription, the effect is obviously limited, and the long-term and huge cost of chronic diseases has become more and more


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